Abstract
We appreciate the letter of Mower et al1 that highlights 2 important issues with the science of cardiac rhythm device (CRD) therapy. First, we should not ignore the possibility that any seemingly small detail of CRD therapy could have an important impact on patient outcomes. Second, as a profession, we should not simply accept technological innovation on the grounds of biological plausibility for benefit. Instead, we should demand rigorous clinical trial evidence of benefit before clinical practice and guidelines are changed.
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