Navigation Links
Doctor's Training Affects Defibrillator Implant Results
Date:4/21/2009

Study finds fewer complications with electrophysiologists

TUESDAY, April 21 (HealthDay News) -- Chances are you've never heard of electrophysiology, but it's a medical subspecialty you should know about if you are one of the 100,000 or so Americans who will have a heart defibrillator implanted this year.

A defibrillator delivers a shock when needed to keep an aberrant heart beating regularly. And the incidence of in-hospital complications is significantly lower when the implant is done by an electrophysiologist rather than an ordinary cardiologist, a thoracic surgeon or a different sort of specialist, according to a study in the April 22/29 edition of the Journal of the American Medical Association.

"Electrophysiology is a subspecialty within cardiology," explained study author Dr. Jeptha P. Curtis, an assistant professor of medicine at the Yale University School of Medicine's section of cardiovascular medicine. "You have to undergo two years of advanced training on the electrical activity of the heart to be eligible for board certification."

The study of a registry of 111,293 defibrillator implants, done between January 2006 and June 2007, found that 70.9 percent of them were performed by electrophysiologists; 21.9 percent were performed by other cardiologists; 1.7 percent by thoracic surgeons; and 5.5 percent by other specialists.

When the procedure was done by an electrophysiologist, complications occurred in 3.5 percent of cases. The incidence was 4 percent for other cardiologists, and 5.8 percent for thoracic surgeons, according to the study.

"Our study suggests that, in general, people are better served by having them [defibrillators] implanted by electrophysiologists," Curtis said.

Another marked difference found in the study concerned people who require an implanted defibrillator that provides cardiac resynchronization therapy (CRT-D). "These are patients with heart failure, in which the heart is not only weak and inefficient but also beats in a disorganized way," Curtis explained.

While a standard implanted defibrillator has one or two "leads" -- electrical wires attached to deliver impulses to the heart muscle -- a CRT-D device uses three leads to keep the heart beating properly. Nearly one-third of the people in the study met criteria for a CRT-D implant, and the likelihood that they would get one was significantly higher when the procedure was done by an electrophysiologist, the study said.

CRT-D devices were implanted by electrophysiologists in 83.1 percent of such cases, compared to 75.8 percent when the implants were done by other cardiologists, 57.8 percent by thoracic surgeons and 74.8 percent by other cardiology specialists.

So a physician's training in electrophysiology can rightly be a matter of concern for someone getting a defibrillator, Curtis said. "I think it is reasonable for a patient to ask a doctor what his qualifications are," he said. "It would be very reasonable for patients to ask implanting physicians what are their results, what are the numbers."

Such information should be available at most large medical centers, and "having that information available should be part of normal quality assurance," Curtis said.

Dr. Stephen C. Hammill is a member of the study group, a professor of medicine at the Mayo Clinic, a past president of the Heart Rhythm Society, and a qualified electrophysiologist. He said the study shows that "across the board as a group, electrophysiologists have a better outcome than cardiologists or thoracic surgeons."

"But it does not show what individual physicians' outcomes are," Hammill added. His recommendation is that anyone considering a defibrillator implant "needs to speak with their physician and be sure that the physician is comfortable with the level of expertise and training of the individual who will do the implant."

Further study is needed to see whether the benefits of having an implant done by an electrophysiologist continue after hospital discharge, Curtis and Hammill said. "We need a follow-up study to see what happens over time," Curtis said.

More information

For more on implantable cardioverter defibrillators, visit the American Heart Association.



SOURCES: Jeptha C. Curtis, M.D., assistant professor, medicine, Yale University School of Medicine, New Haven, Conn.; Stephen C. Hammill, M.D., professor, medicine, Mayo Clinic, Rochester, Minn.; April 22/29, 2009, Journal of the American Medical Association


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. New Research Reveals Need for Doctors to Know About Medical Tattoos
2. Dr. America Comes to Obama's Aid, Helps Doctors Digitize
3. Health-care reform should start with paying evidence-based financial incentives to doctors
4. Tragic choices: Is it better for doctors or patient families to decide?
5. Consumers More Optimistic than Doctors Regarding Future of U.S. Health Care Reform
6. Doctors and Patients to Hold Congressional Briefing on Healthcare Reform April 16
7. Compirion and Henrico Doctors Hospital Team Up to Improve Quality of Care
8. 70% of Contact Lens Cases are Contaminated and Nearly 1 in 4 are Never Replaced - a Serious Problem Eye Doctors Want Fixed, WatchDog Group Reports
9. A Decision Beyond Life and Death: Novel Examines Effects of Controversial Procedure on Patients, Their Families and Doctors
10. Doctors Urged to Get Aggressive to Help Smokers
11. Doctors at Henry Ford Health System Treat Ovarian, Prostate, Lung, and Other Forms of Cancer Using Novalis Tx(TM) Platform for Image-Guided Radiosurgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... ... ... US Sports Camps , official operators of Nike Yoga Camps, announces ... training. ChildLight Yoga Studio is centrally situated in the picturesque New England city of ... founder Lisa Flynn expresses her excitement, “We are thrilled to be partnering with US ...
(Date:2/5/2016)... Texas (PRWEB) , ... February 05, 2016 , ... ... to allow users to search for and donate to Give To Cure’s campaign that ... an app that lets users make and share payments through a smart device. In ...
(Date:2/5/2016)... ... February 05, 2016 , ... Dr. Justin Scott and Dr. ... Annual No Cost Dental Day to individuals in need. The event is scheduled to ... No Cost Dental Day is to provide dental care to community members in need. ...
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... In sleep, ... form as a dream. A hallmark feature of patients with eating disorders is significant ... The eating disorder behaviors and obsessions are regarded as maladaptive means for coping with ...
(Date:2/5/2016)... ... ... Calls Blacklist has just been updated by mobile app developer Vlad Lee. The ... known bugs within the app. Calls Blacklist allows its users to only have to ... their device’s battery power or memory. It provides a powerful call blocker that is ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... LONDON , Feb. 4, 2016 ... and competitive market to drive long-term market growth ... very common set of chronic disorders that affect ... disparate in terms of their symptoms and key ... by dysregulation of immune pathways and an inappropriate ...
(Date:2/4/2016)... -- Omnicell, Inc. (NASDAQ: OMCL ), a leading provider of ... announced results for its fiscal year and fourth quarter ... --> GAAP results: Revenue for the fourth quarter ... 4.1% from the third quarter of 2015, and up ... 2014. Revenue for the year ended December 31, 2015 was ...
(Date:2/4/2016)... Feb. 4, 2016  Aethlon Medical, Inc. (Nasdaq: ... biofiltration devices to treat life-threatening diseases, today announced ... ended December 31, 2015. --> ... set forth in our last quarterly call, we ... our long-term objective to establish the Aethlon Hemopurifier® ...
Breaking Medicine Technology: