Defibrillator malfunctions

A new FDA report indicates that heart defibrillator malfunctions have been increasing while pacemakers are becoming more reliable. Supposedly the number of defibrillator malfunctions is still very low compared to the number of lives saved.When I saw the article (While Pacemaker Failures Fall, Defibrillator Malfunctions Rise) it reminded me of a puzzling NEJM article I blogged about in April. That study showed that combination pacemaker/defibrillator devices were no more effective in reducing mortality than pacemakers alone. That result doesn't really make sense, unless somehow adding the defibrillator makes the whole device less reliable. The combination devices cost about $30,000 and the pacers alone about $12,000-15,000.