New Medtronic Data Shows Health Care Utilization Differs By Type of Implantable Defibrillator Therapy

   Medtronic, Inc. released new data from the MVP (Managed Ventricular Pacing) trial that implantable defibrillator patients receiving anti-tachycardia pacing (ATP) were less likely to have health care utilization after treatment as compared to those receiving shock therapy. Only 24 percent of patients who receive painless anti-tachycardia pacing (ATP) to terminate a potentially life-threatening arrhythmia visited the hospital, clinic or emergency room at least once within three days of receiving therapy, versus nearly 60 percent of patients who were treated with shock therapy. The findings were released at Heart Rhythm 2010.     “This multicenter, international MVP Trial data shows the health care use burden and indicates that both appropriate and inappropriate shocks frequently are associated with hospitalization or urgent care visits,” said Michael O. Sweeney, MD, Cardiac Pacing and Heart Failure Device Therapies, Brigham and Women’s Hospital in Boston.    This MVP study analysis of 1,030 patients also shows that the percentage of appropriately shocked patients who sought medical attention within three days of a shock (56 percent) was similar to that of inappropriately shocked patients (61 percent). However, only 24 percent of patients who receive painless anti-tachycardia pacing (ATP) to terminate a life-threatening arrhythmia had health care use within three days of those treated episodes. Nearly 90 percent of health care utilizations from shocks or ATP included emergency room visits or hospitalizations.    New data on two other shock reduction programming strategy abstracts was released:    • The Shock-Less study preliminary baseline data shows that physician use of evidence-based shock reduction programming strategies remains low and increased adoption is needed. Physicians’ use of recommended device programming for shock reduction improved when their patients enrolled in the trial. However, the improvements still did not meet the desired level of adoption for these proven shock-reducing strategies.    • A prospective analysis shows the Medtronic-exclusive Lead Integrity Alert (LIA) reduced the percentage of patients with inappropriate shocks from lead fracture by nearly 50 percent when compared to patients without LIA.    First released in 2008, the Lead Integrity Alert provides advanced warning of potential lead fractures so the patient can seek medical attention, and reduces the risk of receiving an inappropriate shock. About 75 percent of patients with LIA will receive a three-day warning of a potential lead fracture before receiving an inappropriate shock. While the majority of inappropriate shocks are from SVT, a small percentage can be caused by lead malfunctions.*     “Our clinical studies show the clear benefit of and need for advanced technologies so patients can be reassured their device can precisely detect what arrhythmic episodes require life-saving shock therapy,” said Marshall S. Stanton, MD, vice president of clinical research for the Cardiac Rhythm Disease Management business at Medtronic.