"Implantable devices designed to control heart rhythm and efficiency while preventing sudden death among heart failure patients are as effective at ensuring patient survival in realworld situations as they are in controlled study environments new research suggests. The finding is based on an analysis of nearly  patients outfitted with either an implantable cardioverter defibrillator ICD a cardiac resynchronization therapy device CRT or a defibrillator combined with a CRT device a CRTD. The study authors noted that the observation is somewhat surprising given that some of the patients not enrolled in structured studies have already experienced a cardiac event and are therefore prescribed such devices to prevent a recurrence. This would suggest that realworld heart failure patients as a whole might be more vulnerable to fatal events than those tracked in a study setting. Im very encouraged that survival after defibrillator implant is as good as it is for as long as it is coauthor Dr. Leslie A. Saxon chief of the division of cardiovascular medicine at the University of Southern Californias Keck School of Medicine in Los Angeles said in a news release from the American Heart Association. Theres a lot of good news here she added. Saxon and her team reported their observations in the Nov.  online edition of Circulation. Crunching the numbers the authors determined that  percent of ICD patients survive one year out from device implantation. The same is true for  percent of CRTD patients they noted. Five years out those figures dipped to  percent for ICD patients and  percent for CRTD patients. Among those outfitted with CRT devices alone oneyear survival was pegged at  percent while fiveyear survival came in at  percent the investigators found. The poorer prognosis for CRTonly patients was attributed to their older average age  years and the fact that they may be relatively sicker overall. Patients today tend to receive CRT devices with defibrillators. The study team also found that patients whose implants were monitored remotely on a continual basis by a health facility network were about half as likely to die as patients who only had intermittent inperson assessments. Remote monitoring via telephone lines and online physician access is available for all ICD and CRTD devices the authors noted and enrollment in such programs is typically free with a cardiologists recommendation. Its highly likely the reason these patients did better is that they were receiving earlier diagnoses and they were also empowered to take charge of their own health care more Saxon said. I dont think theres any reason not to put a patient on it. Dr. Eric N. Prystowsky cardiologist and director of clinical electrophysiology at St. Vincent Medical Center in Indianapolis said that the findings are good news but cautioned against overinterpreting the data. These are very basic facts concerning simply who lived and died he noted. So we dont really know what it all means and its inappropriate to suggest that we could based only on this compilation of data. But Prystowsky continued this analysis does show two impressive things one that patients who are not superselected for a trial do well with these devices from a mortality standpoint and two that patients who had homemonitoring had better outcomes. Prystowsky added Now on the latter point again from this data we cant say exactly why that is. But at our facility we think it makes caring for a patient much easier. Physicians knowing things sooner will theoretically give a patient a better chance for quicker access to appropriate care. And that has to be good. So we think theres certainly no downside to remote monitoring and wherever possible its reasonable to want to do this. More information For more on implantable devices visit the American Heart Association http_UCM__Article.jsp. SOURCES American Heart Association news release Nov.   Eric N. Prystowsky M.D. cardiologist director clinical electrophysiology St. Vincent Medical Center Indianapolis"