Defibrillators Outperform Drugs For Arrhythmia

A recent study suggests that defibrillator implants to control arrhythmias save lives – even better than drug therapy. That’s big news for the hundreds of thousands of people with some types of life-threatening, erratic heartbeats.

Recently more than 1,000 patients with serious ventricular fibrillation (fluttering heart muscles which prevent bloodflow) or ventricular tachycardia (speedy beating which depletes blood oxygen) received either an implantable defibrillator or one of two commonly prescribed drugs, amiodarone or sotalol. The defibrillators boosted the one-year survival rate 38% more than that of patients receiving the meds. The advantage dropped to 25% during the second year, but then remained steady. Scientists at the National Heart, Lung, and Blood Institute (NHLBI), which coordinated the 50-site study, were so impressed that they suspended the trial early to avoid unnecessary deaths.

Implantable defibrillators – about the size of a deck of playing cards – act like conductors for the heart: they can’t prevent arrhythmia, but can correct the rhythm with an electric shock. It’s like carrying a tiny emergency room inside you. “We’ve known that implants can do this, but until now, we didn’t know if that meant people would actually live longer. Now we do,” explains Eleanor Schron, RN, NHLBI study director.

Doctors blame most of the nation’s 350,000 annual sudden deaths on faulty heartbeats and estimate that greater use of the implants could save up to 1,000 lives a year. With this impressive number comes another, however: The devices cost about $66,000, including hospital fees, to implant. That’s about twice the initial price of antiarrhythmic drug therapy. Other drawbacks? Implants can lead to infection, need replacement batteries every three to five years, and may be visible in slender people.

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