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Doctors fail to communicate impact of heart devices with patients, SLU study finds
Date:2/18/2013

cians talked more about the technology of the device instead of communicating the expectations patients should have from it."

An ICD is a device placed in the chest or abdomen of a patient that is used by physicians to treat abnormal electrical function of the heart called arrhythmia. The device provides electrical pulses or shocks to help control life-threatening cardiac arrests and is often regarded as a permanent safeguard against arrhythmias.

Hauptman said that asymptomatic patients often receive ICDs as part of a primary prevention strategy, despite the potential of several post-implantation complications that include anxiety and psychosocial changes. Primary prevention strategies are for patients who have not had a sudden death event or symptoms of life-threatening arrhythmias. In secondary prevention, patients have already experienced life threatening cardiac arrhythmias and benefit more from an ICD.

The device, like many technologies, is not free of defects and manufacturers have issued advisories about problems, some of which require corrective procedures to replace parts such as the lead and the generator.

"Seven to eight patients out of a 100 will accrue a survival benefit when the ICD is implanted for primary rather than secondary prevention. The majority will not gain a survival benefit over standard of care," Hauptman said. "Unfortunately, the screening methodology used to identify patients who are at risk of sudden death is not very good."

In the study, 80 percent of patients did not report discussing any potential long-term complications from the device with their physicians before the procedure. They also said that they were not warned about the changes they could expect in the quality of their lifestyles after implanting the device.

Multiple patient participants also experienced difficulty in performing routine physical labor and stated that they now dislike flying because of extra security screening
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Contact: Riya V. Anandwala
ranandwa@slu.edu
314-977-8018
Saint Louis University
Source:Eurekalert

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