Wednesday, April 22, 2009

Need a Defibrillator? Call an Electrophysiologist

There is, after all, strength in numbers. From the national ICD Registry:
Of 111,293 ICD (implantable cardiac defibrillator) implantations included in the analysis, 78,857 (70.9%) were performed by electrophysiologists, 24,399 (21.9%) by nonelectrophysiologist cardiologists, 1,862 (1.7%) by thoracic surgeons, and 6,175 (5.5%) by other specialists. Compared with patients whose ICD was implanted by electrophysiologists, patients whose ICD was implanted by either nonelectrophysiologist cardiologists or thoracic surgeons were at increased risk of complications in both unadjusted (electrophysiologists, 3.5% [2743/78 857]; nonelectrophysiologist cardiologists, 4.0% [970/24 399]; thoracic surgeons, 5.8% [108/1862]; P < .001) and adjusted analyses (relative risk [RR] for nonelectrophysiologist cardiologists, 1.11 [95% confidence interval {CI}, 1.01-1.21]; RR for thoracic surgeons, 1.44 [95% CI, 1.15-1.79]).

Reference: "Association of Physician Certification and Outcomes Among Patients Receiving an Implantable Cardioverter-Defibrillator," JAMA Vol. 301 No. 16, April 22/29, 2009.

1 comment:

Anonymous said...

i am astounded that 20% are implanted by non-ep cardiologists. i wonder what the geographical distribution of the non-ep implanters looks like.