Debate Over Defibrillator Implant Training

Until recently, electrophysiologists, highly trained specialists, performed most defibrillator implants. Defibrillators are devices that treat heart rhythm problems. These devices are implanted in a patient’s body, near their heart. After the federal government recently increased the number of patients for which it would pay for defibrillator implants, there was a rush by more cardiologists to get training in implanting the devices. However, there is controversy surrounding some of the doctor training.

The Heart Rhythm Society, a professional medical organization sponsors classroom training sessions which doctors pay for, while other training sessions are free and given by device manufacturers. Wlith defibrillators costing tens of thousands of dollars, device manufacturers are anxious to attract new practitioners. Companies such as Medtronic, St. Jude Medical and Biotronik, sponsor doctor training in defibrillator implants. The free, manufacturer-sponsored sessions raise concerns about possible conflict-of-interest, since doctors may be influenced when choosing which company’s device to implant in a patient. There are also questions about some elements of the manufacturer-sponsored training sessions, which may not comply with voluntary training guidelines adopted by the Heart Rhythm Society.