The Provincial Guidelines Effect on Risk Based Access to Cardiac Catheterization in Non-St Elevation Acs

Abstract

A total of 897 devices were implanted (22 implants were excluded due to missing information, n¼875). Baseline characteristics are shown in Table I. The mean age was 63 AE13; 82% were male; mean ejection fraction of 0.31 AE0.13 and 62% of implants were for primary prevention. Of the procedures performed, 64% were new implants, 29% were generator changes, and 10% were upgrades. The majority of ICD implants met 'appropriate' (91%) and class I indications (70%) while no procedures had a class III indications (Figure 1). Non-adherence to appropriate use criteria was demonstrated in 14% (n¼48) of implants. Reasons for non-adherence included no existing appropriate use criteria (n¼32, 67%), recent revascularization (n¼8, 17%), research participation (n¼4, 8%) and recent myocardial infarction (n¼4, 8%). CONCLUSION: In this population-based study, we found that our formal process of specialist evaluation and peerreviewed consensus was highly effective at achieving consistency with appropriate use criteria and guideline-derived recommendations.