heart patients are too often given an internal defibrillator

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NOS Nieuws•vandaag, 07:49

Far too often, cardiologists in the Netherlands place an internal defibrillator on patients. According to the National Health Care Institute, such an ICD often contributes nothing to a patient’s chances of survival, while there is a risk of complications, reports de Volkskrant.

Every year 6,000 patients receive an ICD and 1,200 of these would be unnecessary. If they were not placed, it would save 20 million euros in healthcare costs.

According to the Healthcare Institute, the websites of many hospitals are not always honest about the risks of installing an internal defibrillator. The websites mention complication figures of about 1 percent, but in reality more than 8 percent of patients experience a serious complication and people even die when an ICD is placed.

Other treatment methods

These are patients with nicm, non-ischemic cardiomyopathy. This is an umbrella term for all kinds of heart muscle disorders. There are other treatment methods for this, such as medication, the institute says. These treatments have improved in recent years to such an extent that a defibrillator is no longer necessary.

In response to the criticism from the Zorginstituut, cardiologists will present a new guideline before 1 March in which a much more reserved approach to ICDs is advised. According to Cor Allaart, professor of cardiology at Amsterdam UMC, this is a compromise that gives cardiologists a little more room to determine whether a patient benefits from the procedure or not. The Zorginstituut actually wants cardiologists to almost completely stop placing internal defibrillators in patients with NCM.

In de Volkskrant, Allaart says that cardiologists should not be forced to stop implanting on the basis of flimsy evidence. The condition nicm has many subgroups, and according to him it should be examined per subgroup whether an icd is necessary.

Allaart also has difficulty with the image that emerges from the publication of the Healthcare Institute that ICDs are placed because they generate money. “You really shortchange cardiologists with that.”

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