Atrial fibrillation (AF) is a relevant comorbidity in recipients of implantable cardioverter-defibrillators (ICD). Latest generation\nsingle-chamber ICD allow the additional sensing of atrial tachyarrhythmias and, therefore, contribute to the early detection and\ntreatment of AF, potentially preventing AF-related stroke.The present study aimed to measure the impact on patient-related costs\nof this new ICD compared to conventional ICD. A Markov model was developed to simulate the long-term incidence of stroke in\npatients treated with a single-chamber ICD with or without atrial sensing capabilities.The median annual cost per patient and its\ndifference, the number of strokes avoided, and the cost per stroke avoided were estimated. During a 9-year horizon, the costs for\nthe ICD and stroke treatment were â?¬570 per patient-year for an ICD with atrial sensing capabilities and â?¬491 per patient-year for\na conventional ICD. Per 1,000 patients, 4.6 strokes per year are assumed to be avoided by the new device. Higher CHA2DS2-VASc\nscores are associated with higher numbers of avoided strokes and larger potential for cost savings. Apart from clinical advantages,\nthe use of ICD with atrial sensing capabilities may reduce the incidence of stroke and, in high-risk patients, may also contribute to\nreduce overall health care costs.
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