Use of Implantable Cardiac Defibrillators Reviewed

Scientific guidelines and physician judgment should determine application

WEDNESDAY, Aug. 19 (HealthDay News) -- Use of implantable cardioverter-defibrillators should be based on the available scientific evidence and a physician's judgment based on the individual patient, according to a review in the Aug. 25 issue of the Journal of the American College of Cardiology.

Robert J. Myerburg, M.D., and colleagues from the University of Miami reviewed the available evidence to support the use of implantable cardioverter-defibrillators for the prevention of sudden cardiac death and discussed the role of clinical judgment when data are lacking.

The authors note that scientifically-derived guidelines exist based on randomized clinical trials, observational data from high-risk patients with less common diseases, and expert opinion based on limited data in uncommon disorders. However, the design of the randomized trials was not optimal due to insufficient funding, leading to uneven application based partly on post-implant experience.

"Further studies on risk profiling are needed, but in the interim, practicing physicians should recommend devices to their individual patients based upon available data, which they should interpret in the light of individual patient profiles and their patients' preferences," Myerburg and colleagues conclude.

Two authors reported financial or consulting relationships with drug and device companies.

Abstract
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