Arq. Bras. Cardiol. 2024; 121(10): e20240643
Is it Fair to Contraindicate Cardiac Defibrillator Implantation for Patients with Socioeconomic or Psychological Vulnerability?
Marcelo de Paula Martins Monteiro, Helena Nogueira Brasil, Carlos Roberto Martins Rodrigues Sobrinho, Eduardo Arrais Rocha
This Short Editorial is referred by the Research article "Potentially Inappropriate Cardioverter Defibrillator Implants in Secondary Prevention of Death".
The authors Cavalcanti et al. published an article demonstrating that patients undergoing implantation of internal cardiac defibrillators (ICD) for secondary prevention, with ejection fraction (EF) <50%, and who had high socioeconomic or psychological vulnerability presented high mortality in 1 year. The authors analyzed four variables of economic and psychosocial markers (EPSM): 1-socioeconomic vulnerability; 2-self-care capacity; 3-pharmacological adherence; 4- mood disorders. There were no deaths in 1 year in the group without the presence of these variables. The study encompassed a multidisciplinary network of pre-implant analysis called Device-team.
The importance of the study lies in identifying some new markers of worse prognosis after this procedure, particularly in certain population areas. Factors that are subject to modification must be rigorously monitored and modified, enabling evolutionary improvement and ensuring the benefit of increased survival that ICDs provide.
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Keywords: Cardiac Defibrillator; Health Vulnerability; Heart failure
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