The Agency for Healthcare Research and Quality (AHRQ) posted a technology report on decision support tools for cardiac electrophysiology devices, but the effort yielded little evidentiary fruit to support the evaluation. The dearth of data suggests the impact of these tools on clinical decision-making could combine with cost pressures to suppress use of pacemakers and implantable cardioverter defibrillators in patients who are legitimate candidates. However, informed consent issues and questions of device de-activation are likewise conspicuous in the report, leaving researchers with a large set of poorly described variables to be explored in future studies.