ICD Reimbursement

Mortality by Intention-to-Treat Mortality Months of follow-up 36.1% 7.2% year

Mortality by Intention-to-Treat Mortality Months of follow-up

Mortality by Intention-to-Treat Mortality Months of follow-up

DEFINITE Mortality – NYHA FC III No. at Risk Standard ICD Survival Time in Years ICD Standard Probability of Survival 1.0 p=0.009; RR=0.33 STD=16/49 (33%) ICD= 6/47 (13%)

ICD Workup LVEF ≤ 35% NYHA FC QRS Duration (120 ms) Ischemic or nonischemic Cardiomyopathy Duration of NIDCM (3 vs 9 months) Time since last Myocardial Infarction 40 days Time since last PCI or CABG 3 months

ICD Workup Echo 40 days from MI 3 months from PCI or CABG Dyssynchrony if QRS < 120 ms NYHA FC On Beta Blockers & ACE Inibitor QRS Duration (120 ms) No ongoing need for revascularization

Scheduling ICD Implant After CABG or PCI 3 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC After MI 40 day return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC

Scheduling ICD Implant After NIDCM Diagnosis – plan IRB Trial 3 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC After NIDCM Diagnosis – No planned IRB Trial 9 month return, D/C on Beta Blocker & ACE 2D echo, ECG EP consult ICD or BiV ICD prescheduled Determined by NYHA and FC