Regional Variations in Physicians’ Attitudes and Recommendations Surrounding Implantable Cardioverter-Defibrillators

• Published in: Journal of cardiac failure 2011-04, Vol.17 (4), p.318-324
• Main Authors: Matlock, Dan D., MD, Kutner, Jean S., MD, MSPH, Emsermann, Caroline B., MS, Al-Khatib, Sana M., MD, MHS, Sanders, Gillian D., PhD, Dickinson, L. Miriam, PhD, Rumsfeld, John S., MD, PhD, Davidson, Arthur J., MD, MPH, Crane, Lori A., PhD, MPH, Masoudi, Frederick A., MD, MSPH
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Cardiology; Cardiovascular; Defibrillators, Implantable - utilization; Female; frailty; Health Care Surveys; Heart failure; Humans; Male; Multivariate Analysis; Practice Patterns, Physicians' - statistics & numerical data; Practice Patterns, Physicians' - trends; survey
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2010.11.009

Abstract Introduction This study was designed to determine if physicians’ attitudes and recommendations surrounding implantable cardioverter-defibrillators (ICDs) are regionally associated with ICD use. Methods and Results A national sample of 9969 members of the American College of Cardiology was surveyed electronically. Responses were merged with rates of ICD implantation from the National Cardiovascular Data Registry. Multivariable regression was used to assess trends between regional use and responses. We received 1210 responses (12%) and used 1124 after exclusions. Across regions, physicians were equally likely to recommend ICDs to males or females with ischemic (∼99% for both; P = NS) or nonischemic cardiomyopathy (85 vs. 88% P = 0.85). Significant increasing trends in the probability recommending ICD therapy were found when the patient was “frail” (21% to 32%; P = .03) or had a life expectancy