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Published byMelvin Holmes Modified over 9 years ago
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ICD Reimbursement
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Mortality by Intention-to-Treat Mortality Months of follow-up 36.1% 7.2% year
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Mortality by Intention-to-Treat Mortality Months of follow-up
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Mortality by Intention-to-Treat Mortality Months of follow-up
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DEFINITE Mortality – NYHA FC III No. at Risk Standard 35 18 8 3 ICD 38 23 11 3 Survival Time in Years 543210.9.8.7.6.5 ICD Standard Probability of Survival 1.0 p=0.009; RR=0.33 STD=16/49 (33%) ICD= 6/47 (13%)
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ICD Workup LVEF ≤ 35% NYHA FC QRS Duration (120 ms) Ischemic or nonischemic Cardiomyopathy Duration of NIDCM (3 vs 9 months) Time since last Myocardial Infarction 40 days Time since last PCI or CABG 3 months
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ICD Workup Echo 40 days from MI 3 months from PCI or CABG Dyssynchrony if QRS < 120 ms NYHA FC On Beta Blockers & ACE Inibitor QRS Duration (120 ms) No ongoing need for revascularization
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Scheduling ICD Implant After CABG or PCI 3 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC After MI 40 day return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC
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Scheduling ICD Implant After NIDCM Diagnosis – plan IRB Trial 3 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC After NIDCM Diagnosis – No planned IRB Trial 9 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC
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