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Underutilization of Implantable Cardioverter Defibrillators Post Coronary Artery Bypass Grafting in Patients with Systolic Dysfunction
Author(s) -
JOHN JERRY M.,
HUSSEIN AHMED,
IMRAN NASER,
DURHAM SAMUEL J.,
GRUBB BLAIR P.,
KANJWAL YOUSUF
Publication year - 2010
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02700.x
Subject(s) - medicine , ejection fraction , cardiology , bypass grafting , implantable cardioverter defibrillator , coronary artery disease , artery , revascularization , heart failure , myocardial infarction
Background: Evaluation of the need for prophylactic internal cardiac defibrillators among patients with ischemic cardiomyopathies should be deferred until at least 3 months after revascularization procedures to allow adequate time for recovery of ventricular function.Methods: Among patients with left ventricular systolic dysfunction (LVSD) who undergo coronary artery bypass grafting (CABG), the proportion of patients who are risk stratified postoperatively with reassessment of left ventricular ejection fraction (LVEF) is unknown.Results: One hundred and six patients with LVSD (LVEF < 40%) who underwent CABG during 2004–2006 and survived 3 months post CABG were evaluated. Follow‐up was assessed by chart review and telephone contact. LVEF was not reassessed in 24% (25/106) of the population, none of whom underwent internal cardioverter defibrillator (ICD) implantation. Of those with LVEF reassessed, persistent LVSD was present in 20/81 (25%), 12 of whom were referred for prophylactic ICD placement.Conclusion: One‐fourth of patients with LVSD who undergo CABG do not have LVEF reassessed postoperatively which may lead to underutilization of ICDs. (PACE 2010; 33:727–733)