One in Five Patients Get Unneeded Cardiac Implants

One out of five patients who receive a well-known cardiac implant don't need it and are at greater risk of dying of heart attacks because of the device, a US study said.

The survey of more than 100,000 patients who had received implantable cardioverter-defibrillators (ICDs) "found that about 20 percent did not meet evidence-based guidelines for receipt of an ICD," researchers said.

Cardiac Catheterization | Coronary Angiogram - Indications Preparation Procedure Risks Test FAQs
Cardiac catheterization is a radiological procedure for both diagnosis and treatment of heart conditions. It involves the insertion of a long thin flexible tube called catheter a vein or an artery to the heart.

"These patients had a significantly higher risk of in-hospital death than individuals who met criteria for receiving an ICD," they added.

The study was carried out by doctors at Duke Clinical Research Institute and published in the Journal of the American Medical Association (JAMA).

Several clinical trials have shown that ICDs can save the lives of patients with advanced systolic heart failure by detecting irregular rhythms and delivering an electrical shock to the heart to make it beat normally.

Cardiac Markers - Types Indications Cardiac Marker genes Research
Cardiac markers are biomarkers which are measured to evaluate the function of heart. The test for troponin may be regarded as the most sensitive and specific test for myocardial

But they are not recommended for patients recovering from a heart attack or bypass surgery, or for those with severe heart failure symptoms or a recent diagnosis of heart failure.

"The degree to which physicians in routine clinical practice follow these evidence-based recommendations is not clear," the authors of the study said.

Quiz on Heart Attack
The risk factors that work behind the scene before a heart attack are familiar to many. But do you realize the extent to which your lifestyle choices are putting your life at risk? Can you identify a heart attack when it occurs? Take our quiz and find out.

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 percent) were in patients within 40 days of a heart attack, and 15,604 (62.1 percent) were in patients with newly diagnosed heart failure.

Angioplasty - 3D
Interactive section of Medindia gives explanation for Angioplasty - 3D.

The authors admitted that the absolute difference in complications between patients who needed the ICDs and those who did not was "modest" but warned against prescribing unnecessary implants.

"These complications resulted from procedures that were not clearly indicated in the first place," they said.

"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."

Source-AFP