What question did this study set out to answer?

This research aims to assess the prevalence and outcomes of non-evidence-based ICD implants in patients post-myocardial infarction and severe heart failure.

January 4, 2011JAMA

Non–Evidence-Based ICD Implantations in the United States

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Why the study?

Does non-evidence-based ICD implantation increase in-hospital mortality and complications compared to evidence-based ICD implantation in patients receiving primary prevention ICDs?

Population

111,707 patients receiving an implantable cardioverter-defibrillator for primary prevention in the United…

Comparison

Non-evidence-based ICD implantation vs Evidence-based ICD implantation

Design

Cohort

Follow-up

in-hospital

Authors

SASana M. Al‐KhatibElectrophysiology

Discussion

Member takes

Implication

Non-evidence-based ICDs linked to higher procedural risks in observational data; leaves open whether reducing such implants improves outcomes.

Key Points

This research aims to assess the prevalence and outcomes of non-evidence-based ICD implants in patients post-myocardial infarction and severe heart failure.
Retrospective cohort study utilizing data from the National Cardiovascular Data Registry-ICD Registry.
Analysis of 111,707 cases from January 2006 to June 2009.
Comparison of in-hospital outcomes between non-evidence-based and evidence-based ICD recipients.
25,145 patients received non-evidence-based ICDs (22.5%).
Higher in-hospital death rate for non-evidence-based ICDs: 0.57% vs 0.18% (P<.001).
No significant reduction in non-evidence-based ICD implantation rates from 2006 to 2009.

Structured PICO

Does non-evidence-based ICD implantation increase in-hospital mortality and complications compared to evidence-based ICD implantation in patients receiving primary prevention ICDs?

Population

111,707 patients receiving an implantable cardioverter-defibrillator (ICD) for primary prevention in the United States between January 1, 2006, and June 30, 2009.

Intervention

Non-evidence-based ICD implantation (implanted despite recovering from MI or CABG, severe HF symptoms, or recent HF diagnosis)

Comparator

Evidence-based ICD implantation

Outcome

In-hospital outcomes (in-hospital death and any postprocedure complication)hard clinical

Nearly one-quarter of primary prevention ICD implants in the US do not meet evidence-based criteria and are associated with significantly higher in-hospital mortality and complications.

Cite This Study

Sana M. Al‐Khatib (2011) studied this question.

synapsesocial.com/papers/6a06641ccc83fae861778411 https://doi.org/10.1001/jama.2010.1915

Topics

Heart failure HFrEF treatment Cardiac device therapy

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Implication

Non-evidence-based ICDs linked to higher procedural risks in observational data; leaves open whether reducing such implants improves outcomes.

Non–Evidence-Based ICD Implantations in the United States

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Non–Evidence-Based ICD Implantations in the United States

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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