Cardiovascular Disease Clinical Trial
Official title:
Development of and Feasibility Testing of Decision Support for Patients Who Are Candidates for an Implantable Defibrillator
Sudden cardiac death (SCD) due to a ventricular arrhythmia is a serious cause of
cardiovascular death in Canada. The implantable cardioverter defibrillator (ICD) offers
high-risk patients a treatment option to reduce the incidence of SCD by delivering an
internal shock to restore a normal rhythm, if needed. Definitive evidence has established
the effectiveness of the ICD for reducing mortality when used as prophylaxis for SCD (a
primary prevention indication). Approximately 3,700 new candidates accrue annually. Practice
guidelines define the criteria to determine patient ICD candidacy for primary prevention.
However, in addition to SCD risk, ICD candidates may have chronic diseases such as diabetes,
renal insufficiency, hypertension, and atrial fibrillation. Thus, balancing the benefits and
risks of an ICD can become complex, particularly when competing mortality risks are present.
Research has recognized human costs associated with device complications and shocks
affecting psychological, health related quality of life (HRQL), and morbidity outcomes. The
complexities surrounding the long-term benefits/risks, complications, replacements, and
shocks, warrant decision support to prepare patients to make decisions. In Canada, there is
no clear framework to support patients' decision-making in the context of ICD treatment
options. Decision support, using a decision aid, could moderate treatment related
uncertainty and prepare patients to make active, informed, quality decisions.
Objectives: 1) develop a decision aid for ICD candidates to support quality decision-making
(informed, deliberate, values-based choices), 2) to evaluate the decision aid, and 3) to
determine the feasibility of conducting a trial.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Primary Purpose: Health Services Research
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