primary and secondary indication for ICD defibrillator
- related: cardiac pacemaker
- tags: #literature #cardiology
Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy for the primary prevention of sudden cardiac death (SCD) in patients with myocardial infarction (MI) with persistent left ventricular ejection fraction (LVEF) ≤30%, who are at least 40 days post-MI and 3 months post-revascularization (ie, coronary artery bypass grafting or percutaneous coronary intervention, if performed). It is also recommended in those with LVEF ≤35% and NYHA class II or III symptoms, regardless of prior MI.
This patient’s MI was treated with percutaneous revascularization 4 months ago, and he is on optimal medical therapy. He has persistent left ventricular dysfunction with an ejection fraction of 25%. The most appropriate next step is to counsel and offer him ICD placement for primary prevention of SCD.1