Potential impact of antiarrhythmic drugs versus implantable defibrillators on the management of XXXX : the Midlands trial of empirical @entity2643 versus electrophysiologically guided intervention and cardioverter implant registry data.

@entity1 @entity1479 @entity2643 @entity737 @entity2132 @entity583 @entity943
BACKGROUND: Survival was prolonged in selected @entity1 with sustained @entity943 who received @entity737 ( @entity737 ) in the @entity2132 ( @entity2132 ) study. The Midlands trial of empirical @entity2643 versus electrophysiologically guided intervention and cardioverter implant in @entity943 (MAVERIC) registry is a population based trial. OBJECTIVE: To determine the number of @entity1 who satisfy the @entity2132 criteria because of the high cost of @entity737 . DESIGN: Observational study, based on a continuing trial. SETTING: All coronary care units in the Midlands region in the United Kingdom (population 9.1 million). @entity1 : @entity1 presenting to a coronary care unit with sustained @entity943 not related to an acute @entity583 are entered onto the registry. Those who consent to the MAVERIC study are randomised to receive either empirical @entity2643 or electrophysiologically guided treatment. Demographic data, details of clinical presentation, and echocardiographic findings are collected. These data have been used to calculate the number of @entity1 who satisfy the @entity2132 criteria and would benefit from @entity1479 implantation. The financial implications have been calculated for the region and nationally. RESULTS: 132 @entity1 were entered onto the registry during the first five months of the MAVERIC study; 69 @entity1 fulfilled the @entity2132 criteria. Extrapolation of these data over a 12 month period suggests implantation of at least 166 new @entity737 (compared with 23 implants in 1996). This would increase the UK @entity1479 implant rate from five to at least 18 per million of the population, costing the National Health Service 24.1 Pounds million per annum. CONCLUSION: Application of the @entity2132 criteria in the UK will cause a great increase in the @entity1479 implant rate, with serious financial implications.
