Initial Public Comments on Implantable Cardiac Defibrillators
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May 25-June 25, 2004
Name: Gary Ross, DO MS FAAEM
Organization: St. John Hospital Medical Center
Date: May 28, 2004
The DEFINITE and COMPANION trials have truly demonstrated benefit to these devices. The current criteria Medicare uses for bivent devices is a disservice to our patients. I agree the criteria did move closer to the standard of care in Oct. 03, however for devices that have clearly shown improvement in morbidity and mortality, more than any medication we currently offer for heart failure patients, we should be more current. It appears that the QRS width is not needed as part of the criteria. Low EF of 35 and class II or III failure unrelated to a recent MI/revasc procedure is sufficient. The bivent ICD should have its own criteria and not be dependent on the ICD criteria.
The reimbursement also needs to cover the cost of the device and costs associated with the EPS lab.
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