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April 20, 2011

ICD Implantation and Evidence-Based Patient Selection—Reply

JAMA. 2011;305(15):1537-1540. doi:10.1001/jama.2011.461

In Reply: Drs Blake and Swerdlow note that the observation that 22.5% of primary prevention ICDs in the United States do not meet evidence-based guidelines does not mean that all of those implants were not medically appropriate. We agree. We noted in our Editorial that “some variables in the registry may not be accurate” and “some background rate of ICD implantation outside of guideline recommendations” is appropriate. Improvements in data gathering and assisting in medical decision making will help ensure that patients who receive ICDs will be those who are likely to benefit from them. While Blake and Swerdlow are correct that follow-up data on arrhythmia interventions would be interesting and important,1 to date funding to collect these data has not been obtained.

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