More than one-quarter of physicians surveyed never refer patients with the intent of consideration for a primary prevention implantable cardioverter defibrillator (ICD), including 7% of cardiologists, accoring to survey results published in Heart Rhythm.
To determine concordance with primary prevention ICD guidelines from the American College of Cardiology, American Heart Association, and Heart Rhythm Society, reserachres mailed surveys to a random national sample of 3,000 physicians. One third each specialized in general cardiology, internal medicine and family medicine. Fifteen percent surveyed believe ventreicular arrhythmias are required before a primary prevention ICD is indicated, 36% think an ejection fraction >40% warrants a primary prevention ICD and 25% would refer a patient for a primary prevention ICD within 40 days of a myocardial infarction (heart attack).
Multivariate analyses showed the most discordance among family practice physicians and physicians in the western United States. The most concordance to the guidelines was among cardiologists and those that refer to an electrophysiologist.
SOURCE: Cardiology Today