January 6, 2011

Cardiologists May Be Implanting Defibrillators Too Soon

Posted in Heart Disease in the News, Uncategorized tagged , , , , , , , at 11:22 am by keepyourhearthealthy


LifeVests can be given instead of ICD when patients do not meet criteria

The National Cardiovascular Data Registry has released new data suggesting that cardiologists are jumping the gun with ICD’s (Implantable Cardioverter Defibrillators).

Initially, the data seems quite shocking: nearly a quarter of ICD’s were put in despite not meeting the criteria between 2006 and 2009.  The report also goes on to say that the people who received unnecessary ICD’s had more in-hospital complications.  Apparently one of the most popular reasons why these ICD’s did not fall into the guidelines was because the cardiologist did not wait long enough.  The guidelines dictate that you should wait 3 months after a diagnosis of heart failure and at least 40 days after a heart attack before placing an ICD inside someone’s chest. For the most part, the patients who received the ICD’s outside of the guidelines were very sick patients who had a low heart function and were at high risk of deadly heart rhythms.    It seems certain that the cardiologists who implanted the ICD’s had a higher suspicion of poor outcome for these patients and were trying to prevent it.  The fact that those patients were shown to have more complications in the hospital means that the cardiologists were right to suspect a worse prognosis.

As you might expect, this report has started some heated controversy among the clinicians who regularly implant ICD’s.  Comments in response to the article on theheart.org range anywhere from talks of indictment to the blame game to roadblocks for appropriate treatment in the future.  Some clinicians are saying these “inappropriate” ICD’s are more often being put in by cardiologists who do not specialize in putting in devices and are therefore unfamiliar with the guidelines.  Many other clinicians are defending the implants and pointing out the need for treating each patient individually instead of practicing “cookbook medicine.”

A few clinicians have already stepped forward to provide a  solution to the problem of early implants…a LifeVest.  Not the water kind that saves you from drowning but the defibrillator kind that saves you from deadly heart rhythms.  A LifeVest is a wearable defibrillator that can go home with you from the hospital.  As long as you are wearing the vest then you are protected.  This can help get people through the recommended timeline of 40 days after a heart attack or 3 months after a diagnosis of heart failure.  At the end of that timeline a patient may not even require an ICD if their heart has recovered well enough.  Read more about a personal story on the LifeVest at:

Close to the heart | The Times Leader, Wilkes-Barre, PA.

1 Comment

  1. Cardiologists May Be Implanting Defibrillators Too Soon « What To ……

    Here at World Spinner we are debating the same thing……

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