Harvard Health Letter

Shocking news: Overdoing ICDs

Concern about possible overuse of implantable cardioverter-defibrillator devices has led to a reevaluation of their benefits and risks. According to some critiques, ICDs might have been given too much credit for preventing deaths in key clinical trials, when other factors, such as the use of beta blockers, might have been responsible. Others have pointed out that the management of heart failure has improved because of wider use of beta blockers and ACE inhibitor drugs, so the risk of fatal ventricular arrhythmias in heart failure patients has decreased, very possibly making ICDs less useful than they once were. Confidence in ICDs has also been undercut in recent years by recalls of flawed devices. Some doctors have also called for more discussion and consideration of the various drawbacks and complications of ICDs. For example, perhaps as many as one out of every five ICD patients receives an "inappropriate shock" from the device that's triggered by something other than a serious ventricular arrhythmia.
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