Study finds many defibrillators implanted unnecessarily

According to a new study, one in five patients who receive the heart-shocking, life-saving devices known as implantable cardioverter-defibrillators, or ICDs, may be getting them unnecessarily, according to a study published in the Journal of the American Medical Association Tuesday.

The new data looked at four years of national data and found that 22% of the surgeries were in patients who didn’t fit research-backed guidelines. Of the 111,707 initial primary prevention ICD implants that occurred during the study period, 25,145 (22.5 percent) were for a “non-evidence-based indication”.

Of those, 9,257 (36.8%) were in patients within 40 days of a heart attack, and 15,604 (62.1%) were in patients with newly diagnosed heart failure.

ICDs fire an electrical shock to jolt the heart back into a normal rhythm if it starts to beat in a disordered way that can cause sudden death. In people who truly need them, for conditions that can fatally disrupt heart rhythm, defibrillators can be life-saving. However, guidelines recommend against its use in patients recovering from a heart attack or bypass surgery or those with severe heart failure symptoms or a recent diagnosis of heart failure, the researchers explained.

The researcher found that in some cases labeled inappropriate may have been simply because of timing — the precise date of heart failure onset, for example, isn’t always accurately recorded in registries, Kadish and Goldberger noted.

Previous studies looking at the clinical use of ICDs have come to similar conclusions, leading to an investigation last year in to how people are being chosen to receive these devices at hospitals across the country. The stakes of the investigation are high since these devices can be lifesaving, but the cost of implantation of a single ICD can range from $30,000 to $40,000.