August 18, 2008–Fewer than half of eligible patients in the U.S. received medical devices to shock their faulty hearts back into rhythm, though the products can cut death rates by more than one-third, a study found.
Hospitals implanted the $33,000 cardiac resynchronization therapy devices in 12.4 percent of heart failure patients, according to a survey of 34,000 cases published online in the journal Circulation. Previous studies suggest 30 percent to 50 percent of heart failure patients have conditions that make them best suited for the pacemakers, said Jonathan Piccini, a Duke University cardiologist who co-authored the paper.
Cost is a factor at some hospitals, as is the lack of trained specialists to implant the devices and physicians' reluctance to embrace the relatively new technology, Piccini said. Almost 5 million Americans suffer from heart failure, a weakening of the organ that can cause fatigue, physical limitations and ultimately death, according to the St. Paul, Minnesota-based Heart Failure Society of America.
Similar to pacemakers and implantable defibrillators, the pager-sized cardiac resynchronization devices use electrical impulses to zap the heart's pumping back into rhythm, improving the flow of oxygen-rich blood to the rest of the body. Studies have shown the therapy, used with medication and other steps, can cut hospitalizations for heart-failure patients by 50 percent and deaths by 36 percent, said Adrian Hernandez, a Duke cardiologist who worked on the paper.
"There are a lot of patients who potentially could benefit from the device who aren't receiving it," Hernandez said in a statement released by the American Heart Association, which publishes the journal.
The study's authors also found the devices used less often in blacks, older people and those in the Northeast. Black patients were 55 percent less likely than whites to get the CRTs. Heart failure sufferers in the Northeastern U.S. were half as likely to receive the products as those elsewhere in the country and the use of the technology fell the older a patient was above 70, the study said.