Physicians' knowledge of implantable defibrillator treatment: are we good enough?

Abstract

Aims: When admitted to hospitals, patients with an implantable cardioverter defibrillator (ICD) are treated in a variety of departments. Physicians need to have basic ICD knowledge in order to provide the best possible care from implantation to the end of life. The aim of this study was to assess the levels of knowledge concerning ICD treatment among physicians active in Cardiology, Internal Medicine, and Geriatrics.

Methods and results: This cross-sectional comparative study, after stratified sampling, distributed 432 surveys in 18 hospitals with a response rate of 99.5%. As many as 349 (83%) physicians had experience with ICD patients; 288 (68%) rated their ICD knowledge to be low. According to predefined criteria, 175 (41%) physicians' scores reflected sufficient knowledge. There was a significant difference in the level of knowledge between specialities. Sufficient knowledge was reached by 56 (30%) of the physicians in Internal Medicine and 20 (19%) of them in Geriatrics, whereas in Cardiology 99 (71%) reached sufficient knowledge.

Conclusion: There is lack of basic knowledge in ICD treatment and clinical management among physicians. The majority of the respondents had prior experience in treating ICD patients. Over two-thirds of the physicians rated their knowledge to be low, while test scores revealed sufficient knowledge in only 41% of the physicians surveyed. The lack of ICD knowledge is most prominent in Internal Medicine and Geriatrics, but it also extends to physicians in Cardiology departments. With an increasing number of ICD patients, it is of great importance to fill this knowledge gap as soon as possible.

Keywords: Arrhythmias; Clinical competence; Implantable cardioverter-defibrillator; Physician awareness; Physician knowledge; Surveys and questionnaires.