(CHICAGO) – A new study suggests that around 20 percent of patients with an implantable cardioverter-defibrillator do not meet certain guidelines for use of the device.
The ICD, a small electrical impulse generator, is most effective when implanted in patients with advanced systolic heart failure and are therefore at a high risk of cardiac death. The device is not recommended for use in primary prevention or in patients with severe heart failure symptoms and those who have had a recent diagnosis of heart failure.
The study, however, concluded that about 20 percent of more than 100,000 patients who were studied did not meet criteria for its use, and therefore had a significantly greater risk of in-hospital death.
The research, conducted by a group at the Duke Clinical Research Institute, examined cases from January 2006 to June 2009. Results showed that the 22.5 percent of patients who did not meet guidelines for the device had a .57 percent risk of in-hospital death compared to .18 percent in those who did meet criteria for use. The risk of post-procedure complications in those who did not meet criteria was also higher.
“Although the absolute difference in complications between the two groups is modest, these complications could have significant effects on patients’ quality of life and health care use, including length of hospital stay and costs,” wrote the authors. “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.”
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