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ICD Reimbursement Mortality by Intention-to-Treat Mortality Months of follow-up 36.1% 7.2% year.

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Presentation on theme: "ICD Reimbursement Mortality by Intention-to-Treat Mortality Months of follow-up 36.1% 7.2% year."— Presentation transcript:

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2 ICD Reimbursement

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9 Mortality by Intention-to-Treat Mortality Months of follow-up 36.1% 7.2% year

10 Mortality by Intention-to-Treat Mortality Months of follow-up

11 Mortality by Intention-to-Treat Mortality Months of follow-up

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17 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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22 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

23 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

24 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

25 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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