Pacemakers save lives of 9,000 Americans a year

A national study led by a Colorado researcher shows defibrillators and pacemakers save lives; in fact, the devices can save 9,000 Americans a year when combined with the best drug therapy.

"This shows beyond a shadow of a doubt that both devices improve the natural history of heart failure," Dr. Michael Bristow, the lead investigator in the study, said Wednesday.

The study, funded by the Guidant medical device company of St. Paul, Minn., appears in today's issue of the New England Journal of Medicine.

Bristow, head of cardiology at the University of Colorado School of Medicine, said using a defibrillator or pacemaker combined with drug therapy should become the standard of care for the 80,000 to 100,000 Americans who currently fit the profile.

The findings weren't a surprise because doctors have had good success with the devices in the past, reports rockymountainnews.com

According to usatoday.com two years ago, positive findings from a study called Madeit II prompted Medicare and private insurers to pay for the $30,000 device, but only for those with heart failure from heart attacks.

Roughly 5 million Americans have heart failure, also caused by viral infection, alcoholism, high blood pressure, clogged arteries and factors still unknown. Doctors say as many as 100,000 could benefit from the special pacemakers, because the electrical pulses controlling their heartbeat take longer to cross from one pumping chamber to another.

"These devices have great promise," says David Meyerson of Johns Hopkins University and the American Heart Association. "We're seeing improved functional capacity, fewer hospitalizations and improved survival beyond that from the best medicines alone."

Some doctors have asked whether the device's expense will drain Medicare, but Beverly Lorell, chief medical officer for Guidant, the study's sponsor, says her company's device prevents costlier hospitalizations.

However, in some patients with heart failure damage to the muscles of heart prevents electrical signals moving around the organ as they should.

This knocks the rhythm of the heart out of kilter, so that instead of beating simultaneously, its two major chambers - known as the ventricles - beat slightly out of phase.

This reduces the heart's ability to pump blood out into the body with sufficient force.

The new generation of pacemakers can help to re-synchronise the contractions of the heart by stimulating the ventricles simultaneously.

The technique is known as cardiac-resynchronization therapy. It differs from typical pacemakers, which pace only the right ventricle, inform BBC.