Summary of cost-effectiveness recommendations arising from the base case analysis (threshold value: £30 000 per QALY gained)
| NYHA | QRS duration <120 ms | QRS duration 120–150 ms | QRS duration >150 ms |
|---|---|---|---|
| Patients without LBBB morphology | |||
| I* | ICD | ICD | CRT-D |
| II | ICD | ICD | CRT-D |
| III | ICD | CRT-P/CRT-D† | CRT-P/CRT-D† |
| IV | Medical therapy | CRT-P | CRT-P |
| Patients with LBBB morphology | |||
| I* | CRT-D | CRT-D | |
| II | CRT-D | CRT-D | |
| III | CRT-P/CRT-D† | CRT-P/CRT-D† | |
| IV | CRT-P | CRT-P | |
*Results in NYHA I and IV patients are based on relatively low patient numbers and may be subject to bias due to the nature of trial inclusion criteria for NYHA I patients. For further detail see main text.
†Instances where NICE recommended two devices based on fully incremental results and a threshold of £30 000 per QALY gained. CRT-P values are relative to medical therapy and CRT-D values relative to CRT-P.
CRT, cardiac resynchronisation therapy; CRT-D, combined CRT and ICD device; CRT-P, stand-alone CRT device; ICD, implantable cardioverter defibrillator; LBBB, left bundle branch block; NICE, National Institute for Health and Care Excellence; NYHA, New York Heart Association; QALY, quality-adjusted life-year.