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Invited Commentary
April 12, 2010

Best Clinical Practice: Art, Science, or Both?Comment on “Implantable Cardiac Device Procedures in Older Patients”

Author Affiliations

Author Affiliation: Electrophysiology and Pacing Service, Cardiology Division, Mayo Clinic, Jacksonville, Florida.

Arch Intern Med. 2010;170(7):638-639. doi:10.1001/archinternmed.2010.16

Truly successful decision making relies on a balance between deliberate and instinctive thinking. Malcolm Gladwell, Blink: The Power of Thinking Without Thinking, 2005 

Since its inception in the 1980s, the ICD has evolved from a rarely used “last resort” procedure to an essential and commonly used treatment for patients at risk for sudden cardiac death. Approximately 400 000 ICDs were implanted in the United States during the last 3 years, with a current implantation rate of 10 000 to 12 500 ICDs per month.1

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