I find your video most interesting. I also read the references you listed.

In the last month I had an ICD implanted. My cardiologist and electrophysiologist both said that the reason for recommending the ICD was a prior MI and low ef (23%).

My MI was in 2006. I am NYHA class I, 53 years old. I have excellent functional capacity (13 mets). I am on optimal med therapy.

The references listed suggest a 1 to 3 % benefit for having an ICD. To obtain this benefit cost me dearly. I have lost my job as a commercial truck driver (having an ICD is a disqualifying event to retain your medical clearance to keep your commercial drivers license). I now need to find a job in a bad economy for hopefully 1/2 of my prior wage.

It seems like the medical community needs to develop a better risk stratification criteria for recommending an ICD implant (there are many current articles questioning ICD implant criteria and ICD overall effectiveness).

Our society does not sell too many products that cost around $50,000.00 and will benefit only 1, 2 or 3 of every 100 people who buy one.

Great article and references.  Like the truck driver, I, too, have a huge problem with ICD’s and suspect we are being steam-rolled into getting them. As a long-time private pilot, I will forever lose my medical permit if I get an ICD.  (I’ve obviously temporarily grounded myself for now.)  Maybe I’m the exception, being in very good physical shape, but I’ve had zero VT problems since my MI two years ago (while on one of my numerous exercise machines, no less.)  My solution is optimal meds and lots of hard exercise. For two years now, my cardios and EP’s have been pushing in the strongest possible terms for me to get an ICD.  They say that the scar tissue could cause a VF at any time, and that age 64, I’m too young to die.  I’m a very rational guy and have researched this considerably.  Cautious, too, wearing a LifeVest WCD in the meantime (it’s never fired.)  EF has improved from 25% to the mid-30’s and we’re working to build it higher; with luck, it will improve enough to regain my flight medical.  Meanwhile, life is good: I can operate a chainsaw and other power equipment, have had no ICD infections, recalls, or inappropriate shocks, and in another few years, I won’t need a reinstall for batteries.  Oh, and I’ve saved all of us $50k. I join the author and others in calling for a more down-to-earth evaluation of the costs and benefits of ICD’s.  Yes, they are a great device and can save some lives.  But for most users, they are expensive, troublesome, unnecessary, and can have a serious impact on quality of life.  They’re not for everybody.

Well, I knew that despite recovering from a complete stroke 3 years ago, followed by heart failure a year later would end my commercial driving career. Can I still drive? Sure, I could. Would I. Heck no! Well, I can lift probably anything, and having been a line-hauler, I know I can sit longer than any person I know. I can't imagine what kind of work I could do besides being on the road, and having other skills makes no difference. I'm not ready to go and work with the public-at-large. Being on the road keeps you away from misfits and other social hasbins that would otherwise make life a living misery in an adminitrative environment that'll make any trucker puke with desire to just be near a truck stop inhaling diesel. Hell .. I'd rather be in a fist fight over who's turn it is at the fuel pump than struggling to fit-in at some bizarre Help Desk dealing with a bunch of morons who don't know <click> from a drag. But all those years of road fried chicken 'n burgers does a lot of damage. Family history in my case is not the issue, so I'm concluding that diet played a special role in my condition - all 50 years of it, heck - throw in smoking Pall Malls and it just gets clearer to me that smoking played some role in all of it. I just hate it when doctors have just put the blame on "sitting for long periods" as the only factor in DVTs and other heart-related conditions. I just know that if I'd stuck to Tofu most of my life, I'd probably not have had arteries shutting down on me. The job had little to do with it. Stress was nowheretobeseen - shoo, there's more stress in dealing with people "head on face-to-face" than avoiding confused 4-wheelers at the start of a few rain drops in a slippery slope. Road stress is no stress if you're experienced. So what's the plan at 50? Reconfigure and come face-to-face with the fact that I'll never be behind the wheel of a long-nose Pete again. It's just plain facts. Hard facts. Darn it ! But I have to face it. So I'll consider working at (say) a truck stop in exchange for the experience I did acquire. There must be some company out there that'll take on a lot of OTR staff with loads of mileage and experience to refine their current workforce. Maybe?

This comment is to correct my earlier comment in which I wrote that our society does not sell too many products that cost around $50,000.00 and will only benefit 1,2 or 3 people out of every 100 that buy one.

The bills for the 90 minute operation have finally started coming in. As of today, I have received $138,000.00 of medical bills, and i have been told that the doctors billing is yet to come.

I now have first hand knowledge of our countries health care crisis.