Eligible patients who do not identify as White are less likely to see specialists, be counseled on ICDs, and ultimately have an implantable cardioverter-defibrillator implanted.
Significant racial and ethnic disparities exist in the selection, counseling, and implantation of ICDs, highlighting the need for systemic interventions to ensure equitable access to this life-saving therapy.
Racial and ethnic differences in treatment-cardiovascular and otherwise-have been documented in many aspects of the American health care system and can be seen in implantable cardioverter-defibrillator (ICD) patient selection, counseling, and management. ICDs have been demonstrated to be a powerful tool in the prevention of sudden cardiac death, yet uptake across all eligible patients has been modest. Although patients who do not identify as White are disproportionately eligible for ICDs in the United States, they are less likely to see specialists, be counseled on ICDs, and ultimately have an ICD implanted. This review explores racial and ethnic differences demonstrated in ICD patient selection, outcomes including shock effectiveness, and postimplantation monitoring for both primary and secondary prevention devices. It also highlights barriers for uptake at the health system, physician, and patient levels and suggests areas of further research needed to clarify the differences, illuminate the driving forces of these differences, and investigate strategies to address them.
Kiernan et al. (Thu,) conducted a review in Sudden cardiac death and heart failure (ICD eligibility). Implantable cardioverter-defibrillator (ICD) was evaluated. Eligible patients who do not identify as White are less likely to see specialists, be counseled on ICDs, and ultimately have an implantable cardioverter-defibrillator implanted.
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