About 200,000 pacemakers (PMs) are implanted annually for slow heart rate reasons ("brady" indications) in the U.S. as are about 100,00 ICD (intracardiac defibrillators).A smaller number of PMs are implanted for CRT (cardiac resynchronization therapy). Data from 2012 quoted about 35,000 for that indication.
A big increase in ICD use occured after randomized trials showed a morality benefit for ICD in heart failure patients .There were two primary prevention trials- previously ICD were for secondary prevention , i.e patients who had survived a SCD event ( sudden cardiac death)
John Mandrola , writing in Medscape ,makes an interesting case for less use of ICD as does a series of excellent comments by his readers. See here.
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