Use of implantable cardioverter defibrillators in Canada

The use of life-saving implantable cardioverter defibrillators in Canada is rising, but it is still significantly less than that in the United States.

Dr. David Birnie and colleagues from the University of Ottawa Heart Institute report that, between 1995 and 2003, the use of implantable cardioverter defibrillators in adults who survived a cardiac arrest increased from 5.4% to 26.7% in Canada; in the US, the rate went up from 9.7% to 42.0%.

Implantable cardioverter defibrillators are small devices that require only a minor procedure to implant. If a life-threatening abnormal heart rhythm occurs, the device will activate and restore the rhythm to normal. They are considered for use in people who have survived a cardiac arrest and in those who are felt to be at risk of a life-threatening rhythm disturbance.

In a related commentary, Dr. Christopher Simpson asks "How is it that we continue to underuse this safe and effective therapy [in Canada]"? He reviews many potential factors, including economics and bedside rationing, access problems, cultural values and reduced rates of death, and advocates for increased availability of this device.