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Fewer than one in 10 eligible older patients receive an implantable cardioverter-defibrillator within one year of a heart attack, according to a  published yesterday in the Journal of the American Medical Association. ICDs are small devices implanted in the chest or abdomen to help treat irregular heartbeats through the use of electrical pulses or shocks. The study’s authors examined data from more than 10,000 patients aged 65 or older with an ejection fraction of 35% or lower who were potentially eligible for preventative ICD implantation and found the cumulative ICD implantation rate one year after a heart attack was only 8.1%. The average age of the patients was 78. Implantation of an ICD was associated with lower mortality two years post-implantation. The authors note that the transition from inpatient to outpatient care is important for ICD consideration because it is recommended patients wait 40 days after a heart attack before receiving an ICD. “Health system interventions that encourage close outpatient follow-up, improve communication and implementation of longitudinal care plans, and educate patients should be studied to assess whether they can effectively optimize ICD consideration and use,” they said.