Can telemetric home monitoring of implantable defibrillators increase the treatment´s cost-effectiveness ratio?

Implantable defibrillators (ICDs) are the treatment of first choice concerning survived sudden cardiac death (SCD) or symptomatic ventricular tachycardias (VT). Technical progress now offers telemetric performed interrogations and controls including information about the system status, episodes detected and treated via so called home monitoring (HM). Target of this work was to bundle first results and experience from single cases from a systematic clinical investigation (= home - ICD trial) and define a model for an economic research on the cost-effectiveness ratio of the treatment. Till today 228 patients could be included in the trial. On the economic question a Markov-chain model with three abstracted types of complications and three layers of economic benefit could be set up and is shared for discussion.