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The Current Indications for ICD in HF Patients Should be Driven by HF Guidelines

The Current Indications for ICD in HF Patients Should be Driven by HF Guidelines. Mariell Jessup MD Professor of Medicine University of Pennsylvania Philadelphia, Pennsylvania. The data base is the same!!. Secondary Prevention. Incremental Cost-Effectiveness of Cardiovascular Interventions.

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The Current Indications for ICD in HF Patients Should be Driven by HF Guidelines

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  1. The Current Indications for ICD in HF Patients Should be Driven by HF Guidelines Mariell Jessup MD Professor of Medicine University of Pennsylvania Philadelphia, Pennsylvania

  2. The data base is the same!!

  3. Secondary Prevention

  4. Incremental Cost-Effectiveness of Cardiovascular Interventions Total Cost A – Total Cost B Life Expectancy A – Life Expectancy B Economically Unattractive Incremental Cost per Life-Year Saved Expensive Borderline Cost-effective Cost-Effective HighlyCost-Effective PTCA(ChronicCAD, mildangina,1 VD) CABG(Chronic CAD,mild angina,3 VD) Primarycoronarystenting (CAD,Angina, 1 VD,Male, age 55) Lovastatin(chol. = 290 mg/dL,50 yrs old, male, no riskfactors) Hypertensiontherapy(Diastolic95-104mmHg) CardiacTransplant(CHF,transplantcandidate) ICD MADIT ICD AVID ICD MADIT II *Moss AJ. Presentation at Satellite Symposium, “Cost-Effectiveness of Device Therapy in the Heart Failure Population”, Heart Failure Society of America Annual Meeting September 23, 2003.

  5. ESC

  6. The Current Indications for ICD in HF Patients Should be Driven by HF Guidelines • Despite heterogeneity of entry criteria, the HF guidelines across societies and continents are fairly harmonious. • HF physicians respond to system modifications to increase identification of potential patients. • The syndrome of heart failure is a relentless enemy, and death is not always delayed by an ICD

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