Patient and Physician Survey Determinants of Appropriate ICD Utilization

Status:	Active, not recruiting
Conditions:	Cardiology
Therapuetic Areas:	Cardiology / Vascular Diseases
Healthy:	No
Age Range:	18 - Any
Updated:	4/21/2016
Start Date:	August 2011
End Date:	December 2016

Patient and Physician Knowledge and Attitudes Toward Defibrillator Therapy Survey Study

To better understand the reasons for underutilization of defibrillator therapy in selected
populations, the investigators propose a study to assess heart failure patient knowledge and
attitudes toward device therapy. By carefully studying populations of patients with systolic
heart failure, the investigators aim to identify the underlying reasons for implantable
cardioverter defibrillators (ICD) non-utilization in patients with symptomatic systolic
heart failure.

Several multi-center randomized trials have demonstrated the benefit of implantable
cardioverter defibrillators (ICDs) for the primary prevention of sudden cardiac death among
patients with ischemic and nonischemic cardiomyopathy. Guideline documents for the treatment
of heart failure have recommended defibrillator placement for patients with symptomatic
heart failure and left ventricular ejection fraction (LVEF) ≤ 35%. Despite these
recommendations, observational studies have documented low ICD utilization among patients
with heart failure. Recent studies have demonstrated patient specific characteristics that
are associated with low ICD utilization (advanced age, female gender, black race, heart
failure etiology, uninsured patients and patients cared for by general practitioners).
Whether patient knowledge or attitudes regarding defibrillator therapy influence the rate of
defibrillator placement is unknown. By carefully surveying populations of patients with
systolic heart failure, we aim to further the understanding of the patient factors that
determine why an ICD may or may not be used in the appropriate clinical setting.
Additionally, 150 physicians will be enrolled into the study for the purpose of measuring
attitudes and beliefs regarding defibrillator treatment for the physicians providing care to
the patients in the study.

Inclusion Criteria:

- Age ≥ 18 years old

- Left ventricular ejection fraction ≤ 35%

- Previous diagnosis of heart failure with current NYHA Class II-III symptoms

- Established UMHS patient with at least two outpatient visits in the past two years to
either Primary Care or Cardiology, OR, at least one inpatient admission in the past
two years along with at least one outpatient visit within the past 13 months to
Primary Care or Cardiology

Exclusion Criteria:

- Patients having undergone heart transplantation

- Patients having undergone placement of a left ventricular assist device

- Patients with congenital heart disease

We found this trial at

sites

University of Michigan Health System

1500 E Medical Center Dr
Ann Arbor, Michigan 48109

(734) 936-4000