Shared Decision Making in Cardiac Electrophysiology Procedures and Arrhythmia Management

Mina K. Chung, Angela Fagerlin, Paul J. Wang, Tinuola B. Ajayi, Larry A. Allen, Tina Baykaner, Emelia J. Benjamin, Megan Branda, Kerri L. Cavanaugh, Lin Y. Chen, George H. Crossley, Rebecca K. Delaney, Lee L. Eckhardt, Kathleen L. Grady, Ian G. Hargraves, Mellanie True Hills, Matthew M. Kalscheur, Daniel B. Kramer, Marleen Kunneman, Rachel LampertAisha T. Langford, Krystina B. Lewis, Ying Lu, John M. Mandrola, Kathryn Martinez, Daniel D. Matlock, Sarah R. McCarthy, Victor M. Montori, Peter A. Noseworthy, Kate M. Orland, Elissa Ozanne, Rod Passman, Krishna Pundi, Dan M. Roden, Elizabeth V. Saarel, Monika M. Schmidt, Samuel F. Sears, Dawn Stacey, Randall S. Stafford, Benjamin A. Steinberg, Sojin Youn Wass, Jennifer M. Wright

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Shared decision making (SDM) has been advocated to improve patient care, patient decision acceptance, patient-provider communication, patient motivation, adherence, and patient reported outcomes. Documentation of SDM is endorsed in several society guidelines and is a condition of reimbursement for selected cardiovascular and cardiac arrhythmia procedures. However, many clinicians argue that SDM already occurs with clinical encounter discussions or the process of obtaining informed consent and note the additional imposed workload of using and documenting decision aids without validated tools or evidence that they improve clinical outcomes. In reality, SDM is a process and can be done without decision tools, although the process may be variable. Also, SDM advocates counter that the low-risk process of SDM need not be held to the high bar of demonstrating clinical benefit and that increasing the quality of decision making should be sufficient. Our review leverages a multidisciplinary group of experts in cardiology, cardiac electrophysiology, epidemiology, and SDM, as well as a patient advocate. Our goal is to examine and assess SDM methodology, tools, and available evidence on outcomes in patients with heart rhythm disorders to help determine the value of SDM, assess its possible impact on electrophysiological procedures and cardiac arrhythmia management, better inform regulatory requirements, and identify gaps in knowledge and future needs.

Original languageEnglish (US)
Pages (from-to)e007958
JournalCirculation. Arrhythmia and electrophysiology
Volume14
Issue number12
DOIs
StatePublished - Dec 1 2021

Keywords

  • arrhythmias, cardiac
  • decision making, shared
  • documentation
  • electrophysiology
  • informed consent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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