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ICD risk stratification

This article was originally published in The Gray Sheet

Executive Summary

Studies on risk stratification for sudden cardiac death (SCD) are needed "both for clinicians who are faced with the difficult decision of ICD implantation and for a healthcare system that will struggle to remain solvent," Anil Gehi, MD, Mount Sinai School of Medicine, et al., conclude in an editorial in the Aug. 24 issue of the Journal of the American Medical Association. In January, CMS extended coverage for implantable cardioverter defibrillators, making 500,000 Medicare beneficiaries eligible for the devices. However, the authors note that over 81% of patients who received an ICD in the SCD-HeFT trial never used it during the five-year follow-up period. CMS is evaluating a request for national coverage of microvolt T-Wave alternans, an ICD risk-stratification test...
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