0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Cardiac Implantable Electronic Devices: Prevention Starts From Ethics—Reply

Muhammad R. Sohail, MD; Charles A. Henrikson, MD; Daniel J. Lerner, MD
Arch Intern Med. 2012;172(8):670-672. doi:10.1001/archinternmed.2012.839.
Text Size: A A A
Published online

Extract

In reply

We would like to thank Ballo and colleagues for their thoughtful comments on our recent study in Archives.1 We agree that need and benefit of cardiovascular implantable electronic device (CIED) placement should be carefully considered before proceeding with device implantation. A basic principle guiding decisions regarding device placement is to not evaluate the indication for CIED placement2,3 in isolation but to carefully consider the risk of both infectious4 and noninfectious complications associated with implantation. Moreover, the benefit of the device, or lack thereof, in regard to quality of life and long-term survival should be addressed as well. It is the duty of the physician to educate the patient about these risks and benefits, therefore enabling the patient to make an informed decision. When a patient's decision-making capacity is in doubt, caretakers or other individuals with power of attorney should be involved in this complex decision making. We believe that our study contributes to these discussions by elucidating the cost and mortality associated with potential infectious complications of CIED placement.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

April 23, 2012
Piercarlo Ballo, MD; Leandro Chiodi, MD; Alfredo Zuppiroli, MD
Arch Intern Med. 2012;172(8):670-672. doi:10.1001/archinternmed.2012.346.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

45 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Care at the Close of Life: Evidence and Experience
Moral and Legal Framework

Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice, 3rd ed
Ethical Considerations

brightcove.createExperiences();