Consideration for primary prevention implantable cardioverter defibrillators differ between specialities.

Area of Science:

• Cardiology
• Electrophysiology
• Preventive Medicine

Background:

• Implantable cardioverter defibrillator (ICD) implantation rates for primary prevention of sudden cardiac death are variable.
• Guideline recommendations for ICDs exist but are not uniformly applied.

Purpose of the Study:

• To assess if management by a cardiologist influences consideration for ICD implantation in patients with severe left ventricular systolic dysfunction (LVSD).
• To evaluate the impact of physician specialty on ICD consideration and patient outcomes.

Main Methods:

• Retrospective, observational study of 129 patients with severe LVSD identified via echocardiography.
• Patients were categorized into three management groups: electrophysiologist/heart failure specialist, other cardiologists, and non-cardiologists.
• ICD consideration and 1-year survival were assessed cross-sectionally.

Main Results:

• 47.3% of patients with severe LVSD were not considered for an ICD.
• Patients managed by cardiologists were significantly more likely to be considered for an ICD compared to non-cardiologists (63.9% vs. 30.0%).
• Management by an electrophysiologist/heart failure specialist further increased the likelihood of ICD consideration compared to other cardiologists.

Conclusions:

• Physician specialty significantly impacts the consideration of ICD therapy for primary prevention.
• Variations exist among cardiologists and between cardiologists and non-cardiologists in recommending ICDs.
• Optimizing physician awareness and adherence to guidelines may improve ICD utilization for eligible patients.