The New York Times (4/22, B2, Meier) reports that "patients who had heart defibrillators implanted by specialists had fewer serious complications than patients who got them implanted by other types of doctors, according to a" study (pdf) published in the Journal of the American Medical Association. Jeptha P. Curtis, MD, a cardiologist at Yale University, and colleagues used data from the American College of Cardiology's National Cardiovascular Data Registry to review "the experiences of more than 110,000 patients who received defibrillators and other heart devices between January 2006 and June 2007." Altogether, "the study found that the rate of serious complications like heart attacks or internal bleeding that occurred during the implant of a heart device was lowest...when the procedure was performed by an electrophysiologist."

Bloomberg News (4/22, Lopatto) reports that approximately "70 percent of patients have their defibrillators implanted by electrophysiologists, the study found." Meanwhile, "among the others, about 22 percent were inserted by cardiologists who weren't electrophysiologists, two percent were done by thoracic surgeons and about six percent by other specialists." According to Douglas Zipes, MD, a former president of the American College of Cardiology, "There is scientifically credible data to show that the most skilled and trained individual is really one who should be doing this."

HealthDay (4/21, Edelson) reported that "when the procedure was done by an electrophysiologist, complications occurred in 3.5 percent of cases." The researchers found that "the incidence was four percent for other cardiologists, and 5.8 percent for thoracic surgeons."

       

MedPage Today (4/21, Bankhead) reported that, "in an accompanying editorial, James Coromilas, MD, of the University of Medicine and Dentistry of New Jersey in New Brunswick, said the study provides support for a 'compelling argument' that ICD implantation should be performed by a board-certified electrophysiologist whenever possible." Dr. Coromilas added, however, that "the decision to implant a device should not rest with one physician...but should involve the patient's cardiologist, heart failure expert, and the physician who will implant the device." HeartWire (4/21, O'Riordan) and Reuters (4/22, Steenhuysen) also cover the story. For more information on this topic, see Cardiosource.

 

A similar article was also published in the April 22/29, 2009  Journal of the American Medical Association (JAMA).