ICD for NICM All in the Past? - Promedica International CME

ICD for NICM

All in the Past?

Win K. Shen, MD Mayo Clinic Arizona Controversies and Advances in CV Diseases Cedars-Sinai Heart Institute, 2017

?2017 MFMER | 3686275-1

DISCLOSURE

Relevant Financial Relationship(s)

None

Off Label Usage

None

?2017 MFMER | 3686275-2

Objectives

ICD for Non-Ischemic Cardiomyopathy

? Case discussion

? A patient with narrow QRS: ICD or no ICD, and when? ? A patient with LBBB: CRT-D or CRT-P?

? Why the question? ? Evidence-based discussion ? Guidelines, emergent data and take home message

?2017 MFMER | 3686275-3

62 Year-Old Woman

A 62 year-old woman was admitted to the hospital for evaluation of SOB, PND and orthopnea. She was found to be in heart failure. EKG showed SR 90 bpm, QRSD 104 ms. Echo showed an EF of 26%. Angiogram showed no significant CAD. Work up for cardiomyopathy was unrevealing.

? She responded to diuretics. Her discharge medications included metoprolol, valsartan, lasix and K supplement

? She had no signs of heart failure at 3-month follow up. Her functional class was NYHA II. A repeat echo showed the EF was 32%

?2011 MFMER | ?2017 MFMER31| 334689642765--44

Would you recommend ICD?

1. Yes 2. No

?2017 MFMER | 3686275-5

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