Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010;17(3):267-73.

Physicians' knowledge and attitudes regarding implantable cardioverter-defibrillators

Saadia Sherazi  1 , Wojciech Zareba, James P Daubert, Scott McNitt, Abrar H Shah, Mehmet K Aktas, Robert C Block
Affiliations

Physicians' knowledge and attitudes regarding implantable cardioverter-defibrillators

Saadia Sherazi et al. Cardiol J. 2010.

Abstract

Background: Information is limited regarding the knowledge and attitudes of physicians typically involved in the referral of patients for implantable cardioverter-defibrillator (ICD) implantation.

Methods: We conducted a survey of primary care physicians and cardiologists at the University of Rochester Medical Center and the Unity Health System Rochester, NY from December 2008 to February 2009. The survey collected information regarding physicians' knowledge of and attitudes towards ICD therapy.

Results: Of the 332 surveys distributed, 110 (33%) were returned. Over-all 94 (87%) physicians reported referring patients for ICD implantation. Eighteen (17%) physicians reported unawareness of guidelines for ICD use. Sixty-four (59%) physicians recommended ICD in patients with ischemic cardiomyopathy and left ventricular ejection fraction (LVEF) < or = 35%. Sixty-five (62%) physicians use < or = 35% as the LVEF criterion for ICD referral in patients with non-ischemic cardiomyopathy. Cardiologists were more familiar than primary care physicians with LVEF criteria for implantation of ICD in patients with ischemic and non-ischemic cardiomyopathy (p value 0.005 and 0.002, respectively). Twenty-nine (27%) participants were unsure regarding the benefits of ICDs in eligible women and blacks. Eighty two (76%) physicians believed that an ICD could benefit patients > or = 70 years old, whereas only 53 (49%) indicated that an ICD would benefit patients > or = 80.

Conclusions: A lack of familiarity with current clinical guidelines regarding ICD implantation exists. Primary care physicians are less aware of clinical guidelines than are cardiologists. This finding highlights the need to improve the dissemination of guidelines to primary care physicians in an effort to improve ICD utilization.

PubMed Disclaimer

Figures

Fig I
Fig I
Percentage of cardiologist vs primary care who agree that Implantable Cardioverter-Defibrillator therapy benefits women, Blacks, patients above 70 and above 80 year of age.
See this image and copyright information in PMC

References

    1. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, Haase N, Ho M, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell CJ, Roger V, Rumsfeld J, Sorlie P, Steinberger J, Thom T, Wasserthiel-Smoller S, Hong Y. Heart Disease and Stroke Statistics – 2007 Update. A report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2007;115:e69–e171. - PubMed
    1. Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden Cardiac Death in the United States: 1989 to 1999. Circulation. 2001;104:2158–2163. - PubMed
    1. Zipes DP, Wellens HJ. Sudden cardiac death. Circulation. 1998;98:2334–2351. - PubMed
    1. Lombardi G, Gallagher J, Gennis P. Outcome of out-of-hospital cardiac arrest in New York City: the Pre-Hospital Arrest Survival Evaluation (PHASE) Study. JAMA. 1994;271:678–683. - PubMed
    1. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, Levine JH, Saksena S, Waldo AL, Wilber D, Brown MW, Heo M. Improved survival with an implanted defibrillator in patients with coronary artery disease at high risk for ventricular arrhythmia. N Engl J Med. 1996;335:1933–1940. - PubMed

Publication types

MeSH terms