Are Defibrillators Overused?

Implantable cardioverter defibrillators have been shown to reduce the risk of sudden cardiac death in some patients, specifically those with advanced systolic heart failure. A new study shows, however, that this expensive technology is being implanted in many patients who do not meet the guidelines for its use. The researchers analyzed more than 100,000 cases reported to the National Cardiovascular Data Registry-ICD Registry. More than 22 percent of the devices implanted in those patients were for people with newly diagnosed heart failure or those who had recently had heart attacks. These patients, who did not meet guidelines, were significantly more likely to suffer complications and adverse outcomes following the procedure. The scientists note that, “While a small risk of complications is acceptable when a procedure has been shown to improve outcomes, no risk is acceptable if a procedure has no demonstrated benefit.”
[JAMA, January 5, 2011]