Hjärtstopp sker oftast utanför sjukhus, långt ifrån avancerad sjukvård. För varje minut som går utan behandling minskar chansen att överleva avsevärt. Sju av tio personer som drabbats av hjärtstopp får hjärt-lungräddning innan ambulans är på plats. På grund av att fler ingripanden från åskådare sker innan ambulansen är på plats har tiden från hjärtstopp till start av hjärt-lungräddning minskat från 11 minuter till en minut. Syftet med studien är att belysa hur olika faktorer påverkar överlevnaden hos personer med hjärtstopp vid prehospital hjärt- och lungräddning. En litteraturöversikt valdes som metod. Sökningarna genomfördes i databaserna Cinahl ochPubMed och resulterade i 14 artiklar. Ytterligare fyra artiklar inkluderades manuellt. Artiklarna kvalitetsgranskades och klassificerades enligt Sophiahemmets högskolas bedömningsunderlag. Dataanalysen genomfördes med en integrerad analys. Resultatet påvisade att överlevnad efter hjärtstopp är starkt beroende av tiden. Tiden från kollaps till början av hjärt- lungräddning och tiden från kollaps till defibrillering är avgörande för överlevnadschansen. Kedjan som räddar liv (överlevnadsskedjan) representerar olika steg som skall följas vid ett hjärtstopp för att maximera chansen för optimal behandlingsstrategi vid ett hjärtstopp. Slutsatsen är att nya behandlingsstrategier behövs för att nå ut och behandla personer snabbare. AED gör det möjligt för lekmän att leverera livräddande chocker inom några minuter. Vidare gör utvecklingen av mobiltelefonteknik det möjligt att identifiera och rekrytera lekmän till närliggande hjärtstopp för livräddande åtgärder. / Cardiac arrest usually occurs outside hospitals, far from advanced healthcare. For every minute that goes without treatment, the chance of survival decreases significantly. seven out of 10 people who suffer from cardiac arrest receive cardiopulmonary resuscitation before an ambulance is on site. Due to the fact that more interventions from bystanders take place before the ambulance is in place, the time from cardiac arrest to start of cardiopulmonary resuscitation has been reduced from 11 minutes to one minute. The aim of the study is to shed light on how different factors affect the survival of people with cardiac arrest in prehospital cardiopulmonary resuscitation. A literature review was chosen as the method. The searches were performed in the Cinahl and PubMed databases and resulted in 14 articles. Another four articles were included manually. The quality of the articles were reviewed and classified according to Sophiahemmet University's assessment for quality. The data analysis was performed with an integrated analysis. The results showed that survival after cardiac arrest is strongly dependent on time. The time from collapse to the beginning of cardiopulmonary resuscitation and the time from collapse to defibrillation are crucial for the chance of survival. The chain that saves lives (the survivalchain) represents different steps that must be followed in a cardiac arrest in order to maximizethe chance of optimal treatment strategy in the event of a cardiac arrest. The conclusion is that new treatment strategies are needed to reach out and treat people faster. AED enables laymen to deliver life-saving shocks within minutes. Furthermore, the development of mobile phone technology makes it possible to identify and recruit lay peopleto nearby cardiac arrests for life-saving measures.

För att patienten ska ha optimal chans till överlevnad är det av största vikt att rekommendationer i samtliga delar av kedjan som räddar liv följs. Sjuksköterskan är oftast bland de första på plats vid ett hjärtstopp på en vårdenhet, vilket gör det intressant att belysa vilka faktorer som påverkar överlevnaden efter hjärtstopp på sjukhus. Syftet med litteraturstudien var att belysa faktorer i behandlingen av hjärtstopp på sjukhus som påverkar överlevnaden. Genom en sammanställning och analys av vetenskapligt värderad litteratur utfördes en systematisk litteraturstudie i ämnet. Resultatet visade att en väl fungerande organisation, utbildning, monitorering och följsamhet till riktlinjer var framgångsfaktorer i behandling av hjärtstopp. En hjärt-lungräddningsorganisation behövs, vilken organiserar och kvalitetssäkrar utbildning, rutiner, riktlinjer, utrustning och uppföljning. Utbildning av all personal är en förutsättning för framgångsrik behandling. Sjuksköterskan har möjlighet att identifiera och initiera åtgärder, såsom monitorering, vid ett hjärtstopp på sjukhus för att ge patienten största chans till överlevnad. Följsamheten till rekommendationer är låg med risk för att patientens chans att överleva efter ett hjärtstopp minskas. Hjärtstopp på sjukhus har hittills inte varit föremål för forskning i samma mängd som hjärtstopp utanför sjukhus. Speciellt omvårdnadsforskning om åtgärder där sjuksköterskan kan påverka överlevnaden saknas. / In order to achieve the highest survival among patients suffering from in-hospital cardiac arrest, adherence to treatment guidelines are of utmost importance. A nurse is often among the first person on scene when in-hospital cardiac arrest occurs in a regular ward. For this reason, this study explores the factors that may affect survival. The aim of this literature study was to explore factors that affect survival among patients suffering from in-hospital cardiac arrest. Analysis was made on publications found by a systematic search in peer-reviewed publications in the field. The result emphasis the large impact of structure and organization in order to achieve high quality cardiac arrest treatment. There is a need for a centralized cardiopulmonary resuscitation (CPR) management structure in every hospital. This CPR managing group is vital in organizing guidelines, equipment, training and follow-up on treatment results. Training in CPR of all hospital staff is importance for treatment quality. The nurse has the possibility to identify and modify nursing factors such as monitoring level in order to increase chance of detection and thereby the chance of survival in case of cardiac arrest. Current adherence to treatment guidelines is low leading to lower chance of survival. CPR research has so far focused on out-of-hospital cardiac arrest, less focus has been spent on in-hospital cardiac arrest. In particular nursing science concerning areas were nurses are able to affect outcome is lacking.

Bakgrund: Hjärt-och kärlsjukdomar är den vanligaste dödsorsaken i världen. En behandlingsform som skyddar mot hjärt-och kärlsjukdomar i form av plötslig hjärtdöd och livshotande arytmier är en Implanterbar Cardioverter Defibrillator (ICD). ICD-apparaten kan bland annat avge defibrilleringar när hjärtats rytm avviker från normal sinusrytm. Hälsorelaterad livskvalitet kan mätas för att avgöra hur en viss behandling påverkar människors livskvalitet. Hälsorelaterad livskvalitet kan mätas med hjälp av olika mätskalor. Skalorna undersöker bland annat patienters hälsostatus, emotionell och psykisk funktion och hur dessa påverkar det sociala och dagliga livet. Begreppet kan även brytas ner till olika domäner i form av generell livskvalitet samt psykiska domän i form av depression och ångest. Syfte: Syftet med litteraturstudien var att undersöka hur ICD-behandlingen påverkar den hälsorelaterade livskvaliteten hos personer med en implanterbar ICD. Metod: En litteraturstudie med kvantitativ ansats tillämpades och baserades på tolv vetenskapliga artiklar. Resultat: Den hälsorelaterade livskvaliteten hos hjärtsjuka patienter inför en ICD-behandling var signifikant försämrad, i jämförelse med generell befolkning. Den rapporterade livskvaliteten hos hjärtsjuka människor uppmättes som lägst kort innan en ICD-implantation och ICD-behandlingen utgav en signifikant förbättring på livskvaliteten, sex till tolv månader efter implantionen. Ångestrelaterade tankar, depression, den emotionella, psykiska och mentala hälsan angav förbättrade resultat när patienterna fått ICD-behandling, i jämförelse med hur den hälsorelaterade livskvaliteten hos patienterna var före behandlingen. Konklusion: Den hälsorelaterade livskvaliteten tenderade att höjas hos hjärtsjuka patienter som fått en implanterad ICD. Utan ICD-behandling uppmätte hjärtsjuka patienter en signifikant försämrad livskvalitet, i jämförelse med generell befolkning. Däremot försvann den signifikanta skillnaden i hälsorelaterad livskvaliteten mellan hjärtsjuka patienter och generell befolkning efter att de hjärtsjuka erhållit en ICD-behandling. / Background: Heart-diseases are the most common cause of death in the whole world. Treatment that could possibly save patients from sudden cardiac arrest and life-threatening arrhythmias is the Implantable Cardioverter Defibrillator (ICD). The ICD can for instance give defibrillations when the heart departs from regular sinus rhythm. Health-related quality of life can be measured to assess how a certain treatment is affecting peoples’ quality of life. ICD-treatment can be measured in health-related quality of life. Health-related quality of life can be measured with help of different types of measurements and scales. It investigates the patients’ health-status and physical and emotional function and in which way it impacts the daily and social life. Health-related quality of life is a huge concept that can be divided in to smaller domains, like general quality of life and physical symptoms like depression and anxiety. Aim: The aim of this study was to investigate how ICD-treatment infects patients’ health-related quality of life.Method: A literature review with quantitative study-design, based on twelve scientific articles. Result: The health-related quality of life in patients with cardiac problems who are facing an ICD-treatment were significant worse, in comparison with the general population. However, the reported quality of life in patients with cardiac problems was measured at its lowest shortly before the ICD-implantation and the ICD-treatment had a significant improvement on the quality of life, six to twelve months after the implantation. Anxiety-related thoughts, depression, the emotional, physical and mental health indicated a better result when the patients with cardiac problems received an implantable ICD, in comparison with how the health-related quality of life were before the treatment. Conclusion: The health-related quality of life tends to increase after the patients with cardiac problems received an ICD. Without the ICD-treatment, the patients with cardiac problems measure a significantly worse quality of life, in comparison to the general population. However, the significantly worse impact on the quality of life in patients with cardiac problems in comparison with the general population, disappeared after the patients received an ICD.

No description available.

Bakgrund: Implanterbar defibrillator (ICD) är en medicinsk teknisk dosa som bryter livshotande arytmier med en defibrillering. För personer med en förhöjd risk att få ett plötsligt hjärtstopp kan ICD:n vara en direkt livräddande behandling. I dag finns närmare 7800 personer i Sverige som har ICD, vilket är en grupp som stadigt ökar i antal. Syfte: Att beskriva patienters upplevelser av att leva med implanterbar defibrillator. Metod: Litteraturöversikt som baseras på elva vetenskapliga artiklar som analyserats utifrån Fribergs mall för kvalitativ ansats. Resultat: Ur analysen framkom tre huvudteman, Att tappa kontrollen över livet, Ett förändrat liv med begränsningar och en andra chans med sju subteman. Resultatet visar på att patienter med ICD upplever en förändrad livssituation som påverkar dem på ett fysiskt, psykiskt och socialt plan. Reaktioner som osäkerhet, rädsla och oro är vanliga känslor som patienterna upplever. Flera av patienterna utvecklar även ett undvikande beteende på grund av rädsla för tillslag från ICD;n vilket leder till att livskvalité påverkas negativt. Allteftersom som tiden fortskrider så minskas de negativa följderna av behandlingen och de flesta av patienterna känner en djup tacksamhet till att ha fått en andra chans till livet. Diskussion: Sjuksköterskan behöver kunskap om de förändringar och begränsningar som det innebär att leva med en ICD. Samlivet, den fysiska förmågan och arbetslivet påverkas och sjuksköterskan behöver informera om dessa områden för att kunna stötta patienten att anpassa sig till det nya livet. Slutsats: Majoriteten av ICD-bärarna upplever en rädsla för inadekvata tillslag, ovisshet och osäkerhet när ett tillslag kommer att uppstå ligger till grund för de begränsningar patienterna upplever. Sjuksköterskor kommer allt oftare möta denna kategori av patienter vilket gör att det är viktigt med kunskap om deras upplevelser för att kunna möta dem och ge en korrekt vård. / Background: Implantable cardioverter defibrillator is a technological medical controller that interrupts life-threatening arrhythmias with an electrical shock. The ICD could have a direct life-saving impact for persons that have an increased risk to suffer a sudden cardiac arrest. About 7800 people have ICD in Sweden currently, however the group is steadily increasing in numbers. Aim: The aim of this study was to describe the patients' experiences of living with implantable cardioverter defibrillator. Method: Literature overview that is based on eleven scientific articles analyzed based on Friberg’s template for qualitative approach. Findings: Three main topics arose from the analysis after working to the results, To lose control over life, A change life with limitations and A second chance with seven sub-themes. The results points at the patients with ICD goes through a change in their life situation, which affects them at a physical, psychical and social level. Reactions such as insecurity, fear and anxiety are common emotions the patients will feel. Many of the patients will also develop an avoidance behavior because of fear for an electrical shock from the ICD, that will lead to an adverse effect on their quality of life. The negative effects of the treatment will be reduced as time goes on and most of the patients will feel a deeper gratitude to having a second chance to life. Discussion: The nurse needs to know about the changes and limitations that are involved living with an ICD. The co-habitation, the physical ability and the ability to work are all affected and the nurse need to inform the patients about these changes in order to support them to adjust to this new way of life. Conclusion: The majority of ICD-carriers are experiencing a fear of inadequate electrical shock, uncertainty and insecurity when a electrical shock will occur is the basis for the restrictions that patients experiences. Nurses in Swedish healthcare system will encounter this group of patients more often and that makes it crucial that nurses have knowledge about their experiences in order to meet them and give proper care.

Objetivo: Análise da relação custo-efetividade do tratamento com o uso do DCI - Desfibrilador Cardioversor Implantável comparado com o tratamento clínico alternativo através de medicamentos. Revisão de literatura: O estudo contemplou a revisão da conceituação das técnicas de avaliação econômica e de apropriação de custos de procedimentos hospitalares, bem como experiências sobre a análise da relação custo-efetividade aplicadas às intervenções médicas consideradas na pesquisa. Métodos: O estudo utilizou a unidade de Custo por AVG - Ano de Vida Ganho, como expressão do indicador de custo-efetividade. A metodologia compreendeu a definição da perspectiva da pesquisa (Sistema Único de Saúde na qualidade de principal financiador do implante de DCIs, no Brasil), elaboração dos protocolos padrões de tratamento, cálculo dos custos totais dos tratamentos baseados em indicadores praticados por hospitais de referência, os quais encontram-se estimados para o período de dez anos e ajustados para valor presente à taxa de desconto de 6% ao ano. No âmbito da efetividade, foram utilizados parâmetros da literatura, os quais encontram-se baseados nos anos de vida ganhos do tratamento com o uso do DCI, em relação ao tratamento clínico. Resultados: O custo por AVG alcançado pelo estudo foi de R$ 20.530,00, cerca de US$ 9.550. Esse indicador de efetividade foi calculado com base nos parâmetros de custo incremental de R$ 54.200,00 e expectativa de vida de 2,64 anos, decorrentes do uso do DCI comparado com o tratamento clínico. Discussão: O estudo considerou comparações com indicadores da literatura, faixas de atratividade, análises de sensibilidade, impactos sobre financiamento e limitações da pesquisa. Conclusões: O índice de custo-efetividade do tratamento com DCI mostrou-se favorável, sob as condições de atratividade ajustadas à realidade brasileira, embora enfrente dificuldades de financiamento por parte do SUS, considerando o substancial impacto financeiro das indicações de uso do referido tratamento. / Objective: Cost-effectiveness analysis of implantable cardioverter defibrillator therapy (ICD) compared with conventional drug therapy. Literature review: The study comprised the conceptualization of techniques of economic evaluation, the methodology of appropriation of hospital procedure costs and different experiences on cost-effectiveness analysis applied to medical interventions considered in this research. Methods: The study used the unit Cost per Life-Year Gained (LYG) as an index of cost-effectiveness. The methodology included the definition of the research scope (Sistema Único de Saúde as the main payor of the ICD\'s implant, in Brazil), creation of standard protocols of treatment, and calculation of treatment total cost based on indicators used by well known hospitals, which are estimated for ten years and adjusted to a discount rate of 6% a year. Concerning effectiveness, some parameters from the literature were applied, which are demonstrated by LYG with the implant of ICD, compared to the alternative drug therapy. Results: The cost per life-year gained reached by the study was of R$ 20,530.00, approximately US$ 9,550. This ratio of effectiveness was calculated on the basis of the parameters of additional cost of R$ 54,200.00 and the life expectancy of 2.64 years with the use of ICD compared to the drug treatment. Discussion: The study considered comparisons with indicators comprised in the literature, range of attractiveness, sensitivity analysis, impact over financing and limitations of research. Conclusions: The chosen cost-effectiveness indicator for ICD therapy was favorable, under the adjusted attractiveness conditions adapted to the actual Brazilian health care sector. This conclusion holds in spite of the present financial difficulties experienced by SUS, and the substantial financial impact this kind of therapy may generate.

Ser cuidador informal de pacientes com doenças crônicas pode implicar em sobrecarga e sofrimento psicológico significativo, potencialmente prejudiciais para a própria saúde física e mental e para a recuperação do paciente. Pouco se sabe sobre as experiências e características psicossociais dos cuidadores de pacientes portadores de Cardioversor Desfibrilador Implantável (CDI), principalmente na população brasileira, de forma que o presente estudo (quantitativo descritivo transversal) teve por objetivos caracterizar demográfica e psicossocialmente uma amostra não probabilística de cuidadores informais de pacientes portadores de CDI que se encontravam em tratamento médico em um hospital-escola do interior do Estado de São Paulo. As variáveis estudadas incluíram: características sóciodemográficas, qualidade de vida, ansiedade, depressão e percepção de sobrecarga. Participaram da pesquisa 60 cuidadores, entrevistados entre setembro de 2010 a maio de 2011. Para a coleta dos dados foram usados: Roteiro de Entrevista Semiestruturada, elaborado para esta pesquisa, Questionário de Avaliação de Saúde SF-36, Escala Hospitalar de Ansiedade e Depressão e a Zarit Burden Interview. Os dados foram analisados quantitativamente de forma descritiva. Posteriormente verificou-se associação estatisticamente significativa (p<=0,05) entre algumas variáveis de interesse, por meio do Teste Exato de Fisher. Os resultados mostraram que a média de idade dos cuidadores foi de 52,5 anos (DP=14,76), eram em sua maior parte do sexo feminino (n=45, 75%), o cônjuge do(a) paciente (n=39, 65%), com escolaridade predominante de até quatro anos (n=28, 46,67%), sendo a maioria (45, 75%) portadora de problemas de saúde. Vinte e cinco cuidadores (41,67%) apresentaram sintomas indicativos de ansiedade e 13 (21,67%) de depressão. Na avaliação da qualidade de vida, a média de escore mais elevado foi no domínio Aspectos Sociais (Média=78,12, DP=27,48) e o mais baixo em Vitalidade (Média=60,25, DP=26,03). O escore médio relacionado à percepção de sobrecarga foi de 19,93 (DP=12,51, Mediana= 18,5). Os participantes relataram alterações significativas em suas vidas após o implante do CDI, preocupações com a saúde do paciente e funcionamento do dispositivo, dificuldades relacionadas ao papel de cuidador, além de dúvidas sobre o desfibrilador implantável. Os resultados confirmaram que o implante do CDI no paciente impactou significativamente na vida de seus cuidadores informais, sendo necessário o oferecimento de apoio emocional e orientações específicas por parte dos profissionais da saúde para auxiliá-los na adaptação e enfrentamento adequado dessas situações. Dada a escassez de estudos brasileiros nesta população e alguns fatores metodológicos limitantes, é necessário que mais investigações sejam realizadas para comparar estes resultados. / Being an informal caregiver of patients with chronic diseases may imply significant psychological burden and suffering, potentially harmful to caregiver\'s own physical and mental health and patient\'s recovery. Little is known about the psychosocial experiences and characteristics of caregivers of patients with Implantable Cardioverter Defibrillator (ICD), mainly in the Brazilian population, so that the purpose of the present study (transversal descriptive quantitative) was to characterize, both demographically and psychosocially, a nonprobabilistic sample of informal caregivers of patients with ICD undergoing treatment in a university hospital in the interior of the State of São Paulo. The studied variables comprised: sociodemographic characteristics, life quality, anxiety, depression and perception of burden. Sixty caregivers took part in the survey, and they were interviewed between September, 2010 and May, 2011. Data collection used the following instruments: Semi-structured Interview Script prepared for this survey, SF-36 Health Evaluation Questionnaire, Hospital Anxiety and Depression Scale and the Zarit Burden Interview. Data was analyzed quantitatively in a descriptive way. Subsequently, statistically significant association (p<=0,05) was verified between some variables of interest through Fisher\'s Exact Test. Results describe that the average age of caregivers was 52.5 years (DP=14.76), they were mostly female (n=45, 75%), and patient\'s spouses (n=39, 65%), predominantly with up to four years of education (n=28, 46.67%), and most (45, 75%) with health problems. Twenty-five caregivers (41.67%) presented symptoms related to anxiety and 13 (21.67%) to depression. In life quality evaluation, the highest average score was in the Social Aspects dominion (Average=78.12, DP=27.48) and the lowest in Vitality (Average=60.25, DP=26.03). The average score regarding burden perception was of 19.93 (DP=12.51, Median= 18.5). Participants reported significant changes in their lives after ICD implant, concerns about patient\'s health and device operation, difficulties concerning their role as caregivers, in addition to doubts about the implantable defibrillator. Results confirm that the ICD implant had a significant impact in the life of their informal caregivers, requiring provision of emotional support by healthcare professionals in order to help them adapt and properly cope with these situations. Due to the scarcity of Brazilian studies in this population and some limiting methodological factors, further investigation is required to compare these results.

Adults with developmental disabilities may not learn the safety skills needed to maintain the safety of those within their communities. Basic life-saving skills are valued by community members and increase independent and integrated living and employment opportunities. This study used an instructional package consisting of modeling, task analysis, and simultaneous prompting to teach college students with developmental disabilities a basic life-saving skill, specifically how to perform cardiopulmonary resuscitation (CPR) with the use of an automated external defibrillator (AED). Phase 1 of the study used the instructional package to teach the students to perform CPR. Once mastered, Phase 2 of the study taught students to use an AED, incorporating it into the CPR chain. Results showed that the students’ accuracy with the tasks increased after the introduction of the instructional package, generalized to a novel environment, and maintained once the instructional package was removed. Implications and future research are discussed. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2018. / FAU Electronic Theses and Dissertations Collection

En människa som har överlevt ett plötsligt hjärtstopp eller lider av annan livshotande hjärtåkomma kan erbjudas behandling med en implanterbar defibrillator (ICD). Denna kan bryta en livshotande arytmi genom att ge ifrån sig en elektrisk stöt, en defibrillering. Det finns 5564 personer i Sverige som behandlas med ICD och sjuksköterskan kan under arbetslivet någon gång möta dessa patienter. Samtidigt som ICD:n räddar liv så påminns patienten om att kroppen inte längre fungerar som tidigare och detta leder till att livet förändras. Syftet med uppsatsen var därför att få kännedom om hur det är att leva med en ICD och upplevelserna kring detta så att sjuksköterskan kan möta dessa patienter på ett sätt som gynnar vårdprocessen. Metoden som har använts är en litteraturöversikt där kvalitativa artiklar har analyserats. I resultatet framkom fyra huvudteman: upplevelse av kontroll, upplevelse av ett begränsat liv, upplevelsen av stöd och att se livet med nya ögon. Under temat upplevelsen av kontroll framkom tre underteman: tankar och känslor om att få en elektrisk stöt, att förlora kontrollen och att återfå kontrollen. Resultaten visar att rädslan inför att få en elektrisk stöt leder till begränsningar i livet och många svåra frågor och känslor uppkommer. Dessvärre upplever patienterna att det inte finns utrymme att tala om dessa vid återbesöken. Det är viktigt för dem att få prata om detta eftersom det kan underlätta anpassningen till det nya livet. I diskussionen kopplar författarna ihop några upplevelser med vårdvetenskapliga begrepp för att ge en djupare förståelse. Det diskuteras även om det finns riskfaktorer som kan öka patientens upplevelse av ohälsa vid ICD-behandling. Genom en djupare förståelse kan sjuksköterskan möta dessa patienter på ett sätt som främjar vårdprocessen. / Program: Sjuksköterskeutbildning

Objetivo: Análise da relação custo-efetividade do tratamento com o uso do DCI - Desfibrilador Cardioversor Implantável comparado com o tratamento clínico alternativo através de medicamentos. Revisão de literatura: O estudo contemplou a revisão da conceituação das técnicas de avaliação econômica e de apropriação de custos de procedimentos hospitalares, bem como experiências sobre a análise da relação custo-efetividade aplicadas às intervenções médicas consideradas na pesquisa. Métodos: O estudo utilizou a unidade de Custo por AVG - Ano de Vida Ganho, como expressão do indicador de custo-efetividade. A metodologia compreendeu a definição da perspectiva da pesquisa (Sistema Único de Saúde na qualidade de principal financiador do implante de DCIs, no Brasil), elaboração dos protocolos padrões de tratamento, cálculo dos custos totais dos tratamentos baseados em indicadores praticados por hospitais de referência, os quais encontram-se estimados para o período de dez anos e ajustados para valor presente à taxa de desconto de 6% ao ano. No âmbito da efetividade, foram utilizados parâmetros da literatura, os quais encontram-se baseados nos anos de vida ganhos do tratamento com o uso do DCI, em relação ao tratamento clínico. Resultados: O custo por AVG alcançado pelo estudo foi de R$ 20.530,00, cerca de US$ 9.550. Esse indicador de efetividade foi calculado com base nos parâmetros de custo incremental de R$ 54.200,00 e expectativa de vida de 2,64 anos, decorrentes do uso do DCI comparado com o tratamento clínico. Discussão: O estudo considerou comparações com indicadores da literatura, faixas de atratividade, análises de sensibilidade, impactos sobre financiamento e limitações da pesquisa. Conclusões: O índice de custo-efetividade do tratamento com DCI mostrou-se favorável, sob as condições de atratividade ajustadas à realidade brasileira, embora enfrente dificuldades de financiamento por parte do SUS, considerando o substancial impacto financeiro das indicações de uso do referido tratamento. / Objective: Cost-effectiveness analysis of implantable cardioverter defibrillator therapy (ICD) compared with conventional drug therapy. Literature review: The study comprised the conceptualization of techniques of economic evaluation, the methodology of appropriation of hospital procedure costs and different experiences on cost-effectiveness analysis applied to medical interventions considered in this research. Methods: The study used the unit Cost per Life-Year Gained (LYG) as an index of cost-effectiveness. The methodology included the definition of the research scope (Sistema Único de Saúde as the main payor of the ICD\'s implant, in Brazil), creation of standard protocols of treatment, and calculation of treatment total cost based on indicators used by well known hospitals, which are estimated for ten years and adjusted to a discount rate of 6% a year. Concerning effectiveness, some parameters from the literature were applied, which are demonstrated by LYG with the implant of ICD, compared to the alternative drug therapy. Results: The cost per life-year gained reached by the study was of R$ 20,530.00, approximately US$ 9,550. This ratio of effectiveness was calculated on the basis of the parameters of additional cost of R$ 54,200.00 and the life expectancy of 2.64 years with the use of ICD compared to the drug treatment. Discussion: The study considered comparisons with indicators comprised in the literature, range of attractiveness, sensitivity analysis, impact over financing and limitations of research. Conclusions: The chosen cost-effectiveness indicator for ICD therapy was favorable, under the adjusted attractiveness conditions adapted to the actual Brazilian health care sector. This conclusion holds in spite of the present financial difficulties experienced by SUS, and the substantial financial impact this kind of therapy may generate.