Too many people are getting heart defibrillators.
Unsettling fact: A large study concluded that more than 20% of people who have an implanted cardioverter defibrillator (ICD) don’t meet the expert guidelines for who should have the device.
An ICD is a pacemaker-like device that delivers a brief shock when it detects ventricular fibrillation, a life-threatening arrhythmia that can cause cardiac arrest and sudden death. The device is recommended for patients with ventricular defibrillation…those who have already suffered from cardiac arrest…and those with an ejection fraction (a measure of the heart’s pumping ability) below 35% that doesn’t improve with other treatments.
Researchers at Duke University examined nationwide data involving nearly 112,000 patients. Those who received ICDs who did not meet the guidelines were more likely to suffer infections and complications. They spent more time in the hospital and were more likely to die in the hospital.
Why don’t more doctors follow the guidelines? Some simply don’t keep up with the latest recommendations. There also is concern that because Medicare pays $50,000 for the procedure, some hospitals might simply be cashing in. The Department of Justice opened an investigation of ICD overuse in 2010 that is still ongoing.
The guidelines specify a 40-day waiting period after a heart attack before implanting an ICD. If your doctor recommends an ICD sooner than this or if you don’t meet the guidelines above, ask him/her why you need the device. In the study, electrophysiologists (who have the most experience with ICDs) were more likely to follow the guidelines than other doctors.
