Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial

Giuseppe Boriani, Antonis S. Manolis, Raymond Tukkie, Lluis Mont, Helmut Pürerfellner, Massimo Santini, Giuseppe Inama, Paolo Serra, Michele Gulizia, Igor Vasilyevich Samoilenko, Claudia Wolff, Reece Holbrook, Federica Gavazza, Luigi Padeletti

Research output: Contribution to journalArticle

Abstract

Background Many patients who suffer from bradycardia and need cardiac pacing also have atrial fibrillation (AF). New pacemaker algorithms, such as atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), have been specifically designed to reduce AF occurrence and duration and to minimize the detrimental effects of right ventricular pacing. The randomized MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that DDDRP + MVP pacing modality reduced permanent AF in bradycardia patients as compared with standard dual-chamber pacing (DDDR). Objective The aim of this study was to estimate the cost savings due to lower AF-related health care utilization events based on health care costs from the United States and the European Union. Methods Dual-chamber pacemaker patients with a history of paroxysmal or persistent AF were randomly assigned to receive DDDR (n = 385) or the advanced features (DDDRP + MVP; n = 383). We used published health care costs from the United States and the European Union (Italy, Spain, and the United Kingdom) to estimate the costs associated with AF-related hospitalizations and emergency visits. Results The rate of AF-related hospitalizations was significantly lower in the DDDRP + MVP group than in the conventional pacemaker group (DDDR group; 42% reduction; incidence rate ratio 0.58). Similarly, a significant reduction of 68% was observed for AF-related emergency department visits (incidence rate ratio 0.32; P

Original languageEnglish
Pages (from-to)1192-1200
Number of pages9
JournalHeart Rhythm
Volume12
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

    Fingerprint

Keywords

  • Atrial fibrillation
  • Bradycardia
  • Healthcarecosts
  • Hospitalization
  • Pacemakeralgorithms
  • Pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Boriani, G., Manolis, A. S., Tukkie, R., Mont, L., Pürerfellner, H., Santini, M., Inama, G., Serra, P., Gulizia, M., Samoilenko, I. V., Wolff, C., Holbrook, R., Gavazza, F., & Padeletti, L. (2015). Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial. Heart Rhythm, 12(6), 1192-1200. https://doi.org/10.1016/j.hrthm.2015.02.017