ICDs Cut Deaths by 20%
But Most Patients Never Need Jolt From Their Heart-Shock Implants
Aug. 20, 2007 -- ICDs in patients
with heart failure cut death rates by 20%. But most patients never
actually get a therapeutic jolt from their heart-shock implants, a new report
defibrillators -- ICDs -- are lifesavers for people at high risk of sudden
cardiac death. But the sophisticated devices aren't without risk. Is the
benefit really worth it?
Yes, find Justin A. Ezekowitz, MB, BCh, and colleagues at the University of
Edmonton, Alberta, Canada. The researchers analyzed data from all major
clinical trials and observational studies of ICDs.
Having heart failure can put you
at risk for a dangerous abnormal heart rhythm. An ICD monitors the heart rhythm
and shocks the heart when necessary to get it back to a safe rhyth
The bottom line: For a person with
heart failure getting an ICD, the device cuts the overall risk of death
However, no more than one in three patients with an ICD ever gets a
therapeutic shock from the device. This, Ezekowitz and colleagues note,
means that researchers must do a better job of identifying patients who truly
benefit from getting the implant.
The reason is that getting an ICD carries some risks:
- Just over one in 100 patients dies during ICD implant surgery.
- For every 100 years of use, clinical trials suggest, ICDs give 19
inappropriate shocks. Such shocks may increase, rather than decrease, a
patient's risk of death.
Complications can occur after
implantation, such as infection at the implantation site and device
currently implanted with an ICD never receive a therapeutic discharge but are
exposed to the risks of ICDs outlined in our report," Ezekowitz and
The researchers report their findings in the Aug. 21 issue of Annals of