TY  - JOUR
T1  - Dual-chamber implantable cardioverter-defibrillators for nonpacing indications: Comment on “variation in use of dual-chamber implantable cardioverter defibrillators”
AU  - Redberg RF, MD, MSc
Y1  - 2012/04/23
N1  - 10.1001/archinternmed.2012.710
JO  - Archives of Internal Medicine
SP  - 641
EP  - 641
VL  - 172
IS  - 8
N2  - 
Despite the absence of data to support benefit for patients receiving a dual-chamber implantable cardioverter-defibrillator (ICD) compared with a single-chamber ICD for a nonpacing indication, most implants are of dual-chamber ICDs. In contrast to the lack of data for benefit, there are data from multiple randomized and observational trials suggesting increased harm. A recent National Cardiovascular Data Registry (NCDR) analysis found that procedural complications, including in-hospital mortality, were at least 40% greater for dual-chamber compared with single-chamber devices. In this issue, in an analysis of NCDR data from 2006 to 2009, Matlock et al found wide geographic variation with a 4-fold difference in the chance of receiving dual-chamber ICDs. This varied and widespread use of dual-chamber devices for nonpacing indications has no known benefit and definite harms, and is designated as Less Is More.

SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2012.710
UR  - http://dx.doi.org/10.1001/archinternmed.2012.710
ER  -