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Health-care costs skyrocket when defibrillators send needless shocks

16937097910_da40b381ab_oFor people with heart conditions — not the kind a romance might spark — pacemakers and implantable cardioverter defibrillators are devices sent straight from heaven, or um, the doctor’s office. Any time a patient’s heart flutters or skips a beat, the implant sends in an electric shock to put things back in order.

These shocks, however, can sometimes come uninvited when the implant responds to a vibration it’s not meant to treat. Needless to say, too many shocks isn't good for patients.

Now, a team led by Stanford’s Mintu Turakhia, MD, senior director of research at the recently launched Stanford Center for Digital Health, reports that these shocks — lifesaving or not — come with a hefty price tag. The scientists analyzed data in patients implanted between 2008 and 2010 and found that the cost to deal with shocks ranged between about $1,300 and $20,000 per patient for care on procedures like stress tests, cardiac catheterization and echocardiography.

Here’s more from our press release:

[The] researchers were surprised to find that patients who got a shock were hospitalized one out of seven times... 'It didn’t really matter why the shock occurred,' Turakhia said. 'The very fact that any shock happened at all triggered all that stuff happening to the patient.'

These findings indicate that reprogramming the devices so they are smarter and more selective about when to send shocks may help further reduce health care expenditures. At the same time, patients do better if doctors program the ICDs to shock less, or more conservatively, previous studies suggest. 'Fortunately, the industry has made many advancements in this area,' Turakhia said. 'Even older generation devices can be programmed to be smarter. The quality of care is no longer just an issue of whether an ICD was implanted in appropriate patients but also whether it was programmed in the best way possible.'

More than 10,000 people in the United States with heart conditions get ICD implants each month. Today’s news stresses the point that programming the defibrillators to shock less would be a great way to not only reduce healthcare costs, but also improve overall patient health.

The research appears  in Circulation: Cardiovascular Quality and Outcomes.

Previously: Stanford launches Center for Digital Health, Stanford study: Medical procedures more expensive where physicians cluster in large medical practices and Using "big data" to improve patient care: Researchers explore a-fib treatments
Photo by Rosmarie Voegtli

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