Electrophysiologic Studies for Cardiac Arrest

Excerpt

To the Editors: Many general internists like myself (and many lawyers too, I fear) believe that review articles in Annals document the current standards of care. However, I am concerned about the following unqualified recommendation in your recent review on sudden cardiac death (1): "After their underlying heart disease has been defined, patients should have a complete electrophysiologic evaluation, including programmed cardiac stimulation." The clear implication is that such evaluation has proved beneficial in terms of reducing mortality and now represents the standard of care in 1991. In fact, the studies cited do not appear to prove this. What they