Prophylactic ICD therapy

1 month ago I had a cardiac mri, and they found myocardium scarring (most likely from a pervious virus), and now my cardiologist is considering 'Prophylactic ICD therapy', after trialling medication for 3 months to see if my 45% EF improves. What I don't understand is why he would be considering this therapy when I don't have any arythmia's (had a holter monitor test). I am a 57 yr old  masters cyclist (former professional in the 80's), and suffer from shortness of breath.

Has anyone else had similar experiences with recommendations from their cardiologist.


Seems a bit drastic

by PacedNRunning - 2021-04-29 02:50:24

I would get a second opinion.  Seems drastic.  I believe the criteria for ICD is EF less than 35%. HIgher risk for arrhythmia' s. The scaring could be from your years of being strong athlete.  

I wonder if we're lost in the abbreviations here?

by crustyg - 2021-04-29 05:35:20

Quick sanity check (for my benefit): you're sure that it was ICD and not CRT that was being considered?

Might even have meant - or said - CRT-D, but probably CRT-P.

Before seeking a second opinion, I suggest a repeat consultation, and take someone with you.

Second opinion

by Pinkit94 - 2021-04-29 20:13:34

Definitely get a second opinion! However, cyclists (especially master/pro) are at an increased risk for arrhythmias usually due to scarring. Prior to ICD maybe ask your MD to consider a longer-term arrhythmia monitor, such as two-week holter or an implantable loop recorder. 1 Day holters usually are not enough information to determine whether to implant an ICD. As a avid cyclist myself, best of luck to you!

Prophylactic ICD therapy

by Sluggo - 2021-05-04 02:15:39

Hi CrustyG, no he said ICD Therapy, have it in writing, but in saying that when I last actually saw him in his rooms, he did say pacemaker, so maybe he meant crt-d. My CMR said I had lGE pointing to Chronic Myocarditis, have seen some articles about preventative ICD therapy, but rest assured I will be questioning him why an ICD, with only a mild EF reduction and no arythmia, or history thereof. Thanks for all your input.

Thanks for the additional info

by crustyg - 2021-05-04 12:47:29

I agree: CRT-D woud make the most sense.  And from your perspective, being warned that there's an ICD in there, while the CRT does its magic (hopefully) would be important information to have.

I hope it goes well for you.

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