Implantable defibrillators, which are increasingly being used to extend the lives of patients with heart disease, also apparently are being put into many people who shouldn’t be getting the devices.
The result, according to a study published in the Journal of the American Medical Association, is that patients are being exposed to unnecessary hazards — including a higher risk of death — and excessive medical bills.
The study, which analyzed 112,000 recipients of the implanted devices from 2006 through 2009, found that 22.5 percent should have been disqualified from receiving them because they did not meet medical guidelines.
“The rate of [improper] use was astonishingly higher than I expected,” Dr. Sana M. Al-Khatib, who led the study’s team of researchers from Duke University, told the Los Angeles Times.
Defibrillators work by delivering an electronic charge to the heart when it starts to beat irregularly, which can signal the onset of a heart attack. As a result of the charges, the heart’s rhythm is jolted back into its normal pattern, and the risk of cardiac arrest subsides.
But for patients who don’t meet the guidelines, there is no such benefit. Indeed, there often are heightened risks — the study found that patients who improperly received the implants are more than three times as likely to die from complications of the surgery, although the risk of dying remained less than 1 percent. Patients outside of the guidelines also suffer higher incidences of non-fatal complications and endure post-operation hospital stays that, on average, are three times as long.
Patients who are not recommended for the defibrillator implants include those who have suffered a recent heart attack or undergone bypass surgery, as well as those whose with limited life expectancies.
A further issue with the defibrillators is the cost. The devices run from $20,000 to $30,000, and with hospital bills often running the total cost to more than $40,000.
