Abstract 16317: Cost-Effectiveness of Bi-Ventricular Pacemakers vs. RV Pacemakers and Bi-Ventricular Defibrillators vs. Dual Chamber Defibrillators in Patients With Atrioventricular Block and Systolic Dysfunction: All-Patient and Subgroup Analyses From the BLOCK-HF Clinical Trial

BACKGROUND: The cost-effectiveness (C-E) of biventricular (BiV) pacing compared to right ventricular (RV) pacing in patients with a pacing indication due to atrioventricular (AV) block and EF < 50% is unknown. Material differences may exist between the C-E of BiV pacemakers (BiV-P) vs. RV and BiV defibrillators (BiV-D) vs. dual chamber ICDs, the latter when patients independently have an ICD indication. METHODS: Patient-level data from the BLOCK-HF trial were used. Statistical models were used to predict all-cause mortality, NYHA distribution over time, and NYHA-specific HF-related healthcare utilization (HCU) rates. Analyses were undertaken separately for BiV/RV (All-Patient), BiV-P/IPG and BiV-D/ICD. RESULTS: HCU rates in NYHA Classes I/II were lower than Classes III/IV and consistently reduced with BiV devices. Predicted life expectancy in the “All-Patient” analysis was 6.78 years with RV devices and 7.52 with BiV ones (a 10.8% increase). More BiV patients were predicted to remain in, or improve to, Cl...