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Invited Commentary
Less Is More
December 2015

Is Increased Use of Mechanical Circulatory Support Devices Justified?A Cause for Concern

Author Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, University of California San Francisco, Fresno
JAMA Intern Med. 2015;175(12):1982-1983. doi:10.1001/jamainternmed.2015.6093

There has been a significant increase in the use of mechanical circulatory support devices in recent years.1 This increase has been largely due to the availability of several new percutaneous ventricular assist devices (PVADs). Khera et al1 documented in this journal a 30-fold increase in the use of PVADs based on National Inpatient Sample data from 2007 through 2012. In this issue of JAMA Internal Medicine, Inohara et al2 identify frequent use of the intra-aortic balloon pump (IABP) in Japan among patients with guideline-based indications and other less established indications. However, increased implantation of IABPs or PVADs is not supported by any evidence of clinical benefit or by professional guidelines.

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