Comment to PCI, ICD, both, or none?
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MADIT II LVEF < 30%
guideline now recommend ICD :
< 35% if NYHA II-III
or
< 30 % even if NYHA I
or
< 40% + NSVT - MUSTT study recommend VT stim (EP study) - if positive then ICD
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Sorry Khalid, I meant 35% (not 40%, but >40 days post MI) and NYHA-II. His EF by MRI is just above that (39%) which with degree of scarring he has makes me wonder if it will not get any better. Last year I had a patient argued with me on his EF of 38% why not implant ICD. It turned out that he will get disability if he gets ICD, but since I didn't implant it, he fired me!
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