The authors suggest that the low implantation rate may be a consequence of a low referral rate, supply constraints, patient preference and a lag between reported effectiveness of the treatment and its implementation in practice. For survivors of out-of-hospital cardiac arrest, implantable cardioverter defibrillators (ICDs) can reduce the high risk of cardiac arrest recurring. Increasing the number of eligible patients who actually receive an ICD could have a significant impact given that each year 45 000 Canadians die from sudden cardiac arrest.
In a related Analysis article, Davis and Tang explain how the new ICDs work, who should receive them and what a primary care physician can do for a patient with an implant that is delivering shocks.
p. 1053 Use of implantable cardioverter defibrillators after out-of-hospital cardiac arrest: a prospective follow-up study
-- R. Parkash et al.
p. 1037 Implantable cardioverter defibrillators: therapy against Canada 's leading killer.
-- D.R. Davis, A.S.L. Tang.
Canadian Medical Association Journal