Defibrillators Are Lifesaver, but Risks Give Pause

I'm beginning to wonder if I really needed an ICD after reading this article in today's NY Times:

http://www.nytimes.com/2008/09/13/business/13defib.html?_r=1&em=&adxnnl=1&oref=slogin&adxnnlx=1221359394-pABZAjETEDm5vM2hPDvO5w


7 Comments

response to fears

by VIOLIN - 2008-09-14 04:09:19

at some point you need to trust your doctor as to whether a defibrillator is indicated. I would not let any news media(especially the NY TIMES!) come between your medical needs and the decision by your EP doctor to proceed. You may wish two medical opinions instead of one; but i would take the opinion of a non-medical print media reporter with a very large grain of salt.
violin

Article

by ElectricFrank - 2008-09-14 07:09:32

I just read the article and it seems to be very well written and balanced. It makes no attempt to recommend one way or the other.
One thing I didn't see in the article is the death rate attributed to having an ICD. They mentioned the 2 deaths due to the malfunction of the Guidant ICD, but these were only because the device failed to function, not to some side effect that actually killed the patient. I would like to have seen figures on the number of deaths actually caused by having the ICD due either inappropriate shocks or even infections, heart/lung perforations, etc. There must be be some of these.
The other non medical part of the decision is the personal choice about the risk of death. If a person feels they want to reduce the risk of sudden arrest to the lowest possible chance then they need an ICD implanted regardless of diagnosis since no one is free of the risk. If this seems extreme, then at what risk level is the ICD appropriate? Another way to look at it is that all of use who have pacemakers should really have ICD's because we have some underlying heart problem that could turn deadly.

So the advice to "just trust your doctor" is also a personal decision.

Just thinking out loud,

frank

Trust your doctor

by admin - 2008-09-14 07:09:52

Thanks for sharing the story. I agree that you should trust your doctor's opinion. They are the most qualified to diagnose you.

If you still have reservations, I encourage you to discuss this with him/her.

Blake

Why take an avoidable risk

by Rogeroz - 2008-09-15 03:09:14

I don't know what the figures are, but I suspect more lives have been saved by ICDs than have been lost by defects in them. I read the article and it seems there is a financial sub text to it. They are expensive, but is there any evidence that doctors have been over prescribing them? I believe one underibrillated cardiac arrest for any of us is one too many. I was lucky enough to survive once without an ICD and I'm grateful beyond words that this amazing device is now there to "make my luck" should it ever happen again.
Cheers,
Rogeroz

Hi.......

by Bionic Beat - 2008-09-15 12:09:00

Like Frank, I'm just thinking out loud......

Without these devices most of us wouldn't be here or would have some horrid quality of life issues.

Not that these devices are guarantees of quality of life or anything other than wonderful implements that allow us to stay alive.

Everything we do in life is a risk/ratio situation, from crossing the street, driving or eating a meal, you could choke on it.

Eventually, we will all shuffle off this mortal coil, we're not here forever.......just a short time, so have a good time.

We cannot know (usually) when our time will be up but why focus on the issues of dying when we can have so much more fun living.

It's all personal choice but I'd rather think about the future I've got with my pm, than worrying about my last day or how it's going to end.

Everyones' risk of death is 100%, please embrace your life and love it.


Bionic Beat




More NYT's Bull

by mrag - 2008-09-17 09:09:44

I am continually amazed at how far down "our national paper of record" with "all the news that is fit to print" has gone. Jason Blair and Judith Miller were not enough-they keep on going trying to out do the..was it the National Enquier reporting on John Edwards? We know it wasn't the NYT with a story of consequence.

No matter, their typical trash; bottom line-go into "v tack" and you are DEAD. While there are some advantageous things to possibly consider with "v tach,"-seems like it would be quick. merciful and relatively painless for something that is ultimately inevitable for all of us, one big drawback seems to be you don't have much control over the when. To me, it's worth $50,000 of my insurance (or tax dollar) premiums to possibly keep me alive. Although, given the budget, financial market problems, de-regulations, wars on terror and medical care for all, maybe it is time to stop placing these defibrillators in airports, schools and shopping malls. Just as long as I get my replacement battery, the heck with everyone else...and to top it off, their crossword puzzle is still good.

Irresponsible newspapers

by markjbaker - 2008-09-27 02:09:49

ICDs save lives, thousands of lives. Sometimes they do not fire when needed and someone dies, but without that ICD the person would have died for sure. There are recalls, but that does not mean that most ICDs won't work when called upon.

There are risks in the surgery to place the ICD, though it is relatively minor operation/procedure. It will need replacing when the battery has gone, for sure at more risk. But my implant was prescribed, because I have a risk of VF, which will kill me. I escaped SCD the first time, but I won't be so lucky again. Perhaps these scaremongering journos wouldn't go around sewing seeds of doubt if they spoke to some real live ICD users.

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.