Patient expectations from implantable defibrillators to prevent death in heart failure

Abstract

Background. Indications for implantable cardioverter-defibrillators (ICDs) in heart failure (HF) are expanding and may include more than 1 million patients. This study examined patient expectations from ICDs for primary prevention of sudden death in HF. Methods and Results. Study participants (n=105) had an ejection fraction <35% and symptomatic HF without history of ventricular tachycardia/fibrillation or syncope. Participants completed a written survey about perceived ICD benefits, survival expectations, and circumstances under which they might deactivate defibrillation. Mean age was 58 years, mean left ventricular ejection fraction was 21%, 40% had New York Heart Association class III or IV disease, and 65% already had a primary prevention ICD. Most patients anticipated more than 10 years' survival despite symptomatic HF. Nearly 54% expected an ICD to save ≥50 lives per 100 during 5 years. ICD recipients expressed more confidence that the device would save their own lives compared with those without an ICD (P