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Patients Often Ill-Informed on Impact of Heart Device
Date:2/18/2013

ce itself, and not how it would affect their patients.

"We were interested in how physicians communicate with patients and explain the impact of an expensive, invasive technology on quality of life," study co-principal investigator, Eric Armbrecht, director of consulting practice at Saint Louis University Center for Outcomes Research, explained in the news release. "This study revealed physicians talked more about the technology of the device instead of communicating the expectations patients should have from it."

Most study patients initially thought the ICD would provide a cure for their condition, but later realized that wasn't true.

"Patients reported that their physicians described the device as a safety net, calling it absolutely necessary. We found that many patients end up having unrealistic expectations of what the technology is going to do for them," Armbrecht said. "For moral, ethical and economic reasons, patients need to be equipped to make informed decisions about their own health."

The authors noted that some patients without a history of cardiac arrest or arrhythmia symptoms receive an ICD as part of a primary prevention strategy even though the device can lead to side effects, such as anxiety and depression. ICDs may also have mechanical defects, which could require additional procedures to replace parts.

Patients who have experienced a life-threatening arrhythmia benefit more from receiving an ICD as part of a secondary prevention strategy, according to the researchers.

"Seven to eight patients out of 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," noted Hauptman. "Unfortunately, the screening methodology used to identify patients who are at risk of sudden death is not very good."

Doctors need a better way to communicate with their patients, the researchers concluded. "Physicians
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