To evaluate the cost-effectiveness of cardiac resynchronization therapy (CRT) compared with standard optimal medical therapy (OMT) in heart failure patients, highlighting its significance in clinical decision-making.
Key Findings:
Eighteen studies were included in the review.
CRT + OMT showed high cost-effectiveness with ICERs ranging from €3,048 to €71,447/QALY gained (ICERs represent the cost per quality-adjusted life year gained).
CRT-D demonstrated variable cost-effectiveness with ICERs between €24,909 and €105,572/QALY gained.
Interpretation:
CRT, especially CRT-P, is a cost-effective treatment for symptomatic patients with HFrEF despite OMT, while CRT-D should be reserved for high-risk patients due to its variable cost-effectiveness, emphasizing the implications for clinical practice.
Limitations:
The review may not encompass all relevant studies published after July 2025.
Variability in cost-effectiveness across different healthcare settings may limit generalizability, affecting the applicability of findings.
Conclusion:
CRT-P is a high-value therapy for advanced heart failure care, while CRT-D's use should be selective based on patient risk profiles, underscoring the importance of careful patient selection.
Dr. Uprety discusses the current role of non-invasive testing for coronary artery disease, highlighting evidence-based diagnostic strategies and the appropriate use of imaging modalities to improve early detection, risk stratification, and clinical decision-making.
Damon B. Dixon, MD, at Phoenix Children’s Cardiology, is the author to this EndoText chapter. Dr. Dixon brings nationally recognized expertise in pediatric cardiovascular risk assessment and non?invasive vascular imaging.
