ArticlePacing and clinical electrophysiology : PACE2014
"It's not broke, so let's not try to fix it": why patients decline a cardiovascular implantable electronic device.
Article in Pacing and clinical electrophysiology : PACE, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Journal of the American College of Cardiology · 2020Guideline
- 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.Circulation. Cardiovascular quality and outcomes · 2020Guideline
- Article
- Patient Information Needs and Decision-Making Before a Cardiac Implantable Electronic Device: A Qualitative Study Utilizing Social Media Data.Journal of clinical psychology in medical settings · 2025Article
- [Between trivialization and pathologization: Healthcare in old age and the temporal structure of a good life].Ethik in der Medizin : Organ der Akademie fur Ethik in der Medizin · 2023Article
- Patients' knowledge and concerns about using the implantable cardioverter defibrillator for the primary prevention of sudden cardiac death and its correlates: A cross-sectional study.Health science reports · 2022Article
- Primary care heart failure service identifies a missed cohort of heart failure patients with reduced ejection fraction.European heart journal · 2022Article
- A Qualitative Analysis of Patient-Related Factors Associated With Implantable Cardioverter Defibrillator Acceptance.Cardiology and therapy · 2020Article
- Decision-making regarding primary prevention implantable cardioverter-defibrillators among older adults.Clinical cardiology · 2020Review
- Implantable cardioverter defibrillators in the context of hypertrophic cardiomyopathy: a lesson in patient autonomy.BMJ case reports · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundFew patients decline therapy of a cardiovascular implantable electronic device (CIED), and little is known about the characteristics or reasoning of those who do. Our objective was to describe the reasons why patients decline CIED implantation using qualitative methods.
methodsQualitative, engaging thematic analysis. Three patient focus groups led by two trained facilitators and one semi-structured interview guide.
resultsOf the 13 patients, two were women and all were white (median age [range], 65 [44-88] years). Five themes emerged: (1) don't mess with a good thing; (2) my health is good enough; (3) independent decision making; (4) it's your job, but it's my choice; and (5) gaps in learning. Most patients who decline CIEDs are asymptomatic. Other reasons to decline included feeling well, enjoying life, acceptance of the future, desire to try to improve health through diet and exercise, hearing of negative CIED experiences, and unwillingness to take on associated risks of CIED implantation. A medical record review showed that clinicians understand patients' reasons for declining CIED treatment. However, focus group data suggest that gaps in patients' knowledge around the purpose and function of CIEDs exist and patients may benefit from targeted education.
conclusionsPatients decline implantation of CIEDs for various reasons. Most patients who decline therapy are asymptomatic at the time of their device consult. Focus group information show data suggestive that device consultations should be enhanced to address gaps in patient learning and confirm knowledge transfer. Clinicians should revisit treatment options iteratively.
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