Assessment of the Cost-effectiveness of Quadripolar Cardiac Resynchronisation Therapy with Defibrillator (CRT-D).

This study assessed the cost effectiveness of CRT-D with quadripolar leads compared to CRT-D with bipolar leads.  Some of the clinical data was the subject of a separate paper hence in the public domain.  Some of the clinical data were extracted from the study database and were kept confidential during the analysis.  The clinical data was taken from a database of implantations at 3 UK sites in routine practice and hence were real-world but not randomised.  Where required, additional input was obtained from expert (cardiologist) opinion.  The time horizon was 5 years.

Post implantation events were mortality, ACS hospitalisation, arrhythmia hospitalisation, heart failure hospitalisation, device removal and re-implantation for infection, generator (box) change and lead revision procedure.

Sensitivity to changes in the input values was assessed and reported as a Tornado Chart.  Sensitivity to the additional cost of quadripolar CRT-D was also assessed.