Sometimes research affirms what makes sense anyway — but still is compelling and important. Case in point: Recent research published in Journal of the American Medical Association concluded that patients who need an implantable cardioverter defibrillator (ICD) — an implanted electronic device to correct heart rhythm problems — do better when a board-certified electrophysiologist performs the procedure.
An electrophysiologist is basically a cardiologist who specializes in the electrical behavior of the heart and who has undertaken specialized training (usually two years) in this field. In this study of patients at risk of life-threatening arrhythmias, the overall complication rate (meaning any complication from the surgery) with electrophysiologists was 3.5%, and the major complication rate (meaning serious medical events, ranging from cardiac arrest and cardiac-valve injury to death) was 1.3%. This is notably better than the complication rates when the devices are implanted by other types of doctors, such as non-electrophysiologist cardiologists, thoracic surgeons or other specialists, which average 5.8% (any complication) and 2.5% (major complication).
Another advantage — the electrophysiologists were more likely to also use cardiac resynchronization therapy (CRT-D) in heart failure patients who could benefit from this treatment. CRT-D uses a special pacemaker to synchronize the action of the left and right ventricles of the heart. Though the reasons for the difference in application rates of this therapy weren’t explored in the study, I’d venture that it’s likely that electrophysiologists are more up-to-date on the latest technology.
So what does this mean for you? If you’re a candidate for a cardiac implant of any kind — whether it’s a pacemaker, ICD or CRT-D — consider a board-certified electrophysiologist. There are about 1,000 in the US. To find the one nearest you, call the membership services hotline of the Heart Rhythm Society at 202-464-9855. When it’s your heart, any edge you can get is worth the trouble.
