Wide Racial Disparities Found in Heart Device Implantation
African-Americans are significantly less likely than white Americans to receive expensive high-tech implantable defibrillators into the chest to keep their hearts beating regularly, according to a new analysis by cardiologists at Duke University Medical Center.
While the exact reasons for this marked disparity are unclear, the researchers believe that the major barrier facing African-Americans is a lack of access to the latest in appropriate care. Less important factors are patient preferences against invasive procedures and physician bias, they said.
At issue are implantable cardioverter-defibrillators (ICD), devices the size of a deck of cards that are surgically implanted under the skin of the chest, with wires attached to the heart. Whenever the ICD senses that the heart is either beating too fast or too slow, it delivers an appropriate electric impulse to bring the heart back into proper rhythm. ICDs have been proven effective in reducing sudden cardiac death in patients who have already suffered heart attacks.
"As the technology for cardiac devices improves, it is imperative that all patients have equal access to these innovative and life-saving therapies," said DCRI cardiology fellow Kevin Thomas, M.D., who reported the results of his analysis Nov. 15, 2005, at the annual scientific sessions of the American Heart Association in Dallas. "These findings are in line with other studies that have found racial disparities when it comes to other procedures for cardiovascular disease, including coronary artery bypass surgery and angioplasty."
Recent trials have demonstrated the ability of implantable cardioverter-defibrillators to prevent sudden cardiac deaths in patients who have already suffered from a heart attack. The ICDs also help those whose hearts have significantly impaired pumping ability, a situation that often leads to heart failure. Compared to other racial groups, African-Americans with heart failure suffer the highest rates of sudden cardiac death.
To determine whether there were any racial disparities in