Wrong patients may be receiving implanted heart devices
June 11th, 2008 joshua
A St. Louis University professor says too many patients are receiving implantable cardiac devices.
In a recent study, Paul Hauptman, M.D., a professor of internal medicine at St. Louis Univ. says patients too ill to receive any benefit from these devices are needlessly receiving them.
He said the devices shouldn’t be used in “rescue therapy” for patients suffering from cardiac failure. At that point, a patient can’t endure the surgery to implant the device, and it places a higher demand for performance from it.
Not all heart failure patients should be shut out from the treatment, but implanting the devices in patients who’ve previously endured longer hospital stays following an event are less likely to see much benefit from an implanted device.
Hauptman conducted the research by looking at patients with implanted defibrillators, pacemakers or both.
“Decision-making for patients who have very advanced symptomatic heart failure is complex but the guidelines for patient selection emphasize that device implantation should be limited to those who are expected to have, at the very least, a one year life expectancy” Hauptman told ScienceDaily.com.
The average cost of medical treatments to receive an implantable device is nearly $44,000. The cost doubles if a patient implanted with the device, dies.
The study identified inotropic as one major red flag in denying a patient and implantable heart device. In its analysis of hospital records, patients receiving inotropic drugs with or without an implanted device, die before leaving the hospital.
The second red flag in the study was the timing of the procedure. Patients electing to have the device implanted had a higher survival rate than those receiving them during extended hospital stays.
