In Reply: In the study by Dr Curtis and colleagues,1 nonelectrophysiologists were less likely to implant CRT-D devices in patients who met established criteria for CRT-D than were certified electrophysiologists. The proportion of implanted ICDs that were CRT-D devices was higher for electrophysiologists than for the nonelectrophysiologist cardiologists, thoracic surgeons, and other specialists (unadjusted rates of 36%, 33%, 23%, and 31%, respectively). Dr Whittle demonstrated that electrophysiologists were also more likely than the other specialists to implant a CRT-D device even when established criteria for ICD were not met.
Coromilas J. Physician Certification and Implantable Cardioverter-Defibrillators—Reply. JAMA. 2009;302(9):941-943. doi:10.1001/jama.2009.1237