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April 20, 2011

ICD Implantation and Evidence-Based Patient Selection

JAMA. 2011;305(15):1537-1540. doi:10.1001/jama.2011.456

To the Editor: The study by Dr Al-Khatib and colleagues called into question physician compliance with guidelines supporting implantable cardioverter-defibrillator (ICD) therapy.1 Our concern is that the authors defined ICD implantation within 3 months of a new heart failure (HF) diagnosis for all patients as non–evidence based. We believe this does not accurately reflect the Centers for Medicare & Medicaid Services (CMS) reimbursement criteria2 or the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACC/AHA/HRS) 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities.3