The recent approval by the US Food and Drug Administration (FDA) of the Absorb GT1 bioresorbable vascular scaffold (BVS) system (Abbott Vascular) got me thinking about a modern-day medical problem: the tension between progress and safety. Precarious is the balance between embracing the new and sticking with the tried and tested—pioneer vs Luddite. Interventional cardiologists are known for their pioneering spirit. By definition, a pioneer takes risks and sometimes suffers consequences. We allow novel devices leeway because future iterations of a new device often prove beneficial.
In general, current-generation drug-eluting stents (DES) perform better than the original versions. But newer is not always better. The heart rhythm community, including me, in my gullible days, accepted low-profile implantable cardioverter-defibrillator (ICD) leads . This embrace had disastrous consequences…
