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European Heart Journal Advance Access originally published online on February 8, 2007
European Heart Journal 2007 28(4):386-387; doi:10.1093/eurheartj/ehl518
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The cost of implantable defibrillators: how the perception of reality depends on perspective

Hein Heidbüchel*

University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium

* Corresponding author. Tel: +32 16 34 42 48; fax: +32 16 34 42 40. E-mail address: hein.heidbuchel@uz.kuleuven.ac.be

This editorial refers to ‘The high cost of implantable defibrillators’{dagger} by M.A. Hlatky and D.B. Mark, on page 388

‘The cost of implantable defibrillators: perceptions and reality’{ddagger} by J. Camm et al., on page 392

{dagger} doi:10.1093/eurheartj/ehl311 Back

{ddagger} doi:10.1093/eurheartj/ehl166 Back

The first 150 words of the full text of this article appear below.

The implantable cardioverter defibrillator (ICD) has been the subject of controversy since its very inception. Although Michel Mirowski had a visionary idea about how implantable devices could prevent arrhythmic sudden death, his vision immediately met criticism. Twenty-five years later, the skepticism has moved from issues of feasibility and effectiveness, raised by colleagues, to questions about cost and cost-effectiveness, asked by society. The discussion shows the evolution from evidence-based to value-based medicine.1 By entering the health-economic arena, arguments have evolved from medically and scientific to economic and even ethical, where standards for evaluation are much less well defined than outcomes of randomized trials.

Two opinion papers in this issue of the journal2,3 illustrate the persisting controversy around ICD therapy and its current stage. Both agree on the evidence that secondary ICD implantation (i.e. after a prior cardiac arrest or haemodynamically compromising ventricular tachycardia) and prophylactic ICD implantation in patients . . . [Full Text of this Article]


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Related articles in EHJ:

The high cost of implantable defibrillators
Mark A. Hlatky and Daniel B. Mark
EHJ 2007 28: 388-391. [Abstract] [Full Text]  

The cost of implantable defibrillators: perceptions and reality
John Camm, Helmut Klein, and Seah Nisam
EHJ 2007 28: 392-397. [Abstract] [Full Text]  



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