Researchers have found they can sharply reduce the death rate in high-risk heart attack patients with small but costly devices that can be tucked under the skin of the chest and can avert potentially fatal heart rhythms.
The devices, implantable defibrillators, sense when the heart’s rhythm is going awry and emit an electric shock to the heart to bring its fluttering rhythm back to normal.
The new study found that the device was effective in patients whose hearts were so damaged from heart attacks that they no longer could pump effectively.
Implantable defibrillators are routinely used for a relatively small group of patients who have demonstrable heart rhythm disturbances.
The new study showed that the devices are effective in a much larger group of people– those who have had serious heart attacks that place them at risk for heart rhythm disturbances but who may not have had such problems.
There are 400,000 new patients a year who could benefit from the device, but it costs about $20,000 and an additional $10,000 to implant it.
“We’re looking at changes that could easily rupture the health-care budget,” said Dr. Douglas Zipes, president of the American College of Cardiology.
The study’s results were released Tuesday at the annual meeting of the American College of Cardiology and will be published Thursday in the New England Journal of Medicine.
It found that, after an average of 20 months of follow-up, 19.8 percent of those who did not have the devices died, compared with 14.2 percent of those who had them, a 30 percent difference in the overall death rate.
For now, insurance companies and Medicare pay for limited use of the defibrillators in those who have had previous heart arrhythmias.
