TY - CHAP M1 - Book, Section TI - Cardiac Cardioverter Defibrillators (ICDs) in Heart Failure A1 - Kahwash, Rami A2 - Baliga, R. R. A2 - Abraham, William T. PY - 2018 T2 - Color Atlas and Synopsis of Heart Failure AB - A 55-year-old man with past medical history significant for hypertension (HTN), hyperlipidemia, and type 2 diabetes mellitus, was admitted to the coronary care unit 3 months ago with non-ST-elevation myocardial infarction (NSTEMI). Coronary angiography then revealed 95% narrowing in the proximal left anterior descending coronary artery. He underwent successful percutaneous coronary intervention and stent placement with excellent angiographic results and resolution of his symptoms. His left ventricular ejection fraction (LVEF) was 25% by left ventriculography performed at the time of the intervention. He was established on dual antiplatelet therapy, statin, and guideline-directed medical therapy for heart failure (HF). Beta blocker and angiotensin-converting enzyme (ACE) inhibitor were gradually titrated to the maximally tolerated doses during the next few months after discharge. He returned for his 3-month post discharge visit reporting no angina. An echocardiogram in the office revealed an LVEF of 30%. His 12-lead electrocardiogram (ECG) showed normal sinus rhythm (NSR), normal intervals, old septal infarct, and QRS of 110 ms. His medications include carvedilol 25 mg by mouth twice daily, lisinopril 10 mg by mouth twice daily, spironolactone 25 mg by mouth once a day, aspirin 81 mg by mouth once a day, clopidogril 75 mg by mouth once a day, and atorvastatin 80 mg by mouth before bed. He resides in NYHA functional class II. What is the single most important therapy you recommend to improve his survival? SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1161018357 ER -