Referral Patterns for Primary Prophylaxis Implantable Cardioverter Defibrillator Therapy for an Urban US Population

The American Journal of Cardiology
Eric D ManheimerKevin J Ferrick

Abstract

Implantable cardioverter defibrillators (ICDs) have been demonstrated to improve survival for both primary and secondary prevention of sudden cardiac arrest. However, studies suggest that ICD therapy is underused in appropriate candidates. Sex and racial disparities in ICD use have been suggested. We sought to characterize the referral patterns of high-risk patients for the primary prophylaxis of sudden cardiac arrest at a tertiary academic medical center serving a diverse population in an urban US setting. Electronic hospital databases were retrospective reviewed for patients meeting criteria for prophylactic ICD implantation. We evaluated the association of gender, age, race, and primary language with the referral and subsequent implantation of an ICD. We identified 1,055 patients satisfying prophylactic ICD criteria: 600 men, mean age 62.6 years, 27.6% black, 19.3% white, 23.3% Hispanic, and 49.8% primary language of English. Of the 673 patients (63.7%) referred for ICD evaluation, 345 underwent implantation, 125 declined, and 203 had significant co-morbidities that precluded implantation. Gender, race, and primary language were not associated with referral for ICD or with decision to proceed with implantation. Patients of i...Continue Reading

References

Sep 19, 2000·Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology·P Della Bella
Feb 15, 2002·Journal of Cardiovascular Electrophysiology·Jeremy N RuskinMary E McGrory-Usset
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Jan 31, 2006·The American Journal of Medicine·Andre J GauriBradley P Knight
Nov 15, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Darryl R DavisDavid H Birnie
Oct 4, 2007·JAMA : the Journal of the American Medical Association·Lesley H CurtisKevin A Schulman
Oct 4, 2007·JAMA : the Journal of the American Medical Association·Adrian F HernandezEric D Peterson
Nov 11, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Ure MezuSamir Saba
Jun 24, 2015·JAMA : the Journal of the American Medical Association·Sean D PokorneyTracy Y Wang

❮ Previous
Next ❯

Citations

Feb 14, 2016·Herz·M Block
Jun 16, 2018·Journal of Neurosurgery. Spine·Eric Z HerringMichael P Steinmetz
Sep 17, 2020·Journal of General Internal Medicine·Ankur SrivastavaAndrew K Krumerman

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.