Since their inception in the early 1980s implantable cardioverter defibrillators (ICDs) have helped thousands of patients avoid cardiac death. However, new research by Ratika Parkash and colleagues show only a minority of eligible patients in selected communities in Ontario received an implant over a five-year period beginning in 1997.

The authors suggest that the low implantation rate may be a consequence of a low referral rate, supply constraints, patient preference and a lag between reported effectiveness of the treatment and its implementation in practice. For survivors of out-of-hospital cardiac arrest, implantable cardioverter defibrillators (ICDs) can reduce the high risk of cardiac arrest recurring. Increasing the number of eligible patients who actually receive an ICD could have a significant impact given that each year 45 000 Canadians die from sudden cardiac arrest.

In a related Analysis article, Davis and Tang explain how the new ICDs work, who should receive them and what a primary care physician can do for a patient with an implant that is delivering shocks.

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Contact: Dr. Graham Nichol
nichol@uwashington.edu
Canadian Medical Association Journal
25-Oct-2004

Page: 1
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