To the Editor: For ICD implants, electrophysiologists are currently described as the specialists. Electrophysiologists may generally have superior catheter skills and have a higher success rate placing transvenous left ventricular leads for cardiac resynchronization-capable devices (a minority of implants). It appears that thoracic surgeons are relegated to fixing implant complications (removing infected devices, managing cardiac perforations) and performing the more difficult primary implants: subpectoral implant in cachectic patients, subcutaneous implant in morbidly obese patients, and implants in patients with complex anatomy who have failed initial attempt by an electrophysiologist.
Lick SD, Kollar AC, Conti VR. Physician Certification and Implantable Cardioverter-Defibrillators. JAMA. 2009;302(9):941-943. doi:10.1001/jama.2009.1234