Decision Support for Implantable Cardioverter-Defibrillator Replacement: A Pilot Feasibility Randomized Controlled...

Area of Science:

• Cardiology
• Medical Decision Making
• Health Technology Assessment

Background:

• Implantable cardioverter-defibrillators (ICDs) require battery replacement, presenting patients with a significant decision.
• Effective decision support is crucial for patients to align choices with personal preferences.

Purpose of the Study:

• To assess the feasibility of a decision support intervention for patients considering ICD replacement.
• To evaluate the impact of decision support on patient knowledge, decision conflict, and involvement.

Main Methods:

• A pilot randomized feasibility trial involving 30 patients nearing ICD battery depletion.
• Patients were randomized to receive a decision support intervention or usual care.
• Feasibility assessed via recruitment, intervention use, and data completeness; secondary outcomes included knowledge and decision quality.

Main Results:

• The decision support intervention was feasible to deliver, with high data completeness.
• Patients receiving the intervention demonstrated significantly improved knowledge about ICD replacement (77.4% vs 51.1%).
• Acceptance rates for ICD replacement were similar between groups, with one patient in each arm declining.

Conclusions:

• The decision support intervention is feasible for patients facing ICD replacement.
• The intervention shows potential to enhance the quality of decisions regarding ICD replacement.
• Further research is warranted to optimize recruitment and confirm benefits.