I have decompensated heart failure and an enjection fraction of 13%. This started in August last year. I am now on several different medications and feel well but my heart is not improving. Would a ICD or pacemaker be beneficial?
Dr. Matt Faircloth
Dr. Matt Faircloth
Cardiologist
Frimley
It is quite likely that an ICD would be beneficial in terms of reducing long term risks. A biventricular pacemaker/ICD might be indicated depending on the ECG (specifically the QRS duration). It would be sensible to raise these questions with your cardiologist.

I agree, an ICD may be beneficial, but a careful discussion with a cardiologist about all the management options would be crucial.

Dr. Abdullah Mohammed
Dr. Abdullah Mohammed
Cardiologist, Internist
Liverpool
ICD would be beneficial to improve prognosis especially if the cause of heart failure is ischaemic heart disease (previous heart attacks).
If ECG showed wide QRS duration then ICD with heart pacing device would be beneficial which would also improve symptoms.

Dr. Fahad Farooqi
Dr. Fahad Farooqi
Cardiologist, Lipidologist, Echocardiologist
Goodmayes, Ilford
An ICD will not improve heart pump function or symptoms relating to heart failure, but it can improve prognosis by treating potentially life threathening rhythm disturbances which people with severe heart failure are at risk of developing. ICDs are however, not suitable for everyone with heart failure and the pros and cons should be considered and discussed with your cardiologist.

Dr. Shaumik Adhya
Dr. Shaumik Adhya
Cardiologist
Gillingham
I agree with my colleagues above. In some patients with heart failure the ECG shows that the heart is not being activated as quickly as it should (the ECG shows bundle branch block). This results in parts of the heart muscle contracting at different times to the rest of the heart muscle. Bit like an engine that's out of tune. A Biventricular pacemaker can improve this and make the heart beat more efficiently. This is frequently combined with an ICD. It's definitely worth discussing with your doctor

Dr. Ronak Rajani
Dr. Ronak Rajani
Cardiologist
I would agree with all of my colleagues above. Likely you would meet criteria for a pacemaker/ICD but this would need to be determined on a per patient basis with an understanding of the pros and cons of various pacemakers and what functions they serve.

Dr. David Ramsdale
Dr. David Ramsdale
Cardiologist
Liverpool
ICD may improve prognosis a bit especially if ischaemic heart disease is the causal factor. If the ECG shows wide QRS duration then a CRTD (ICD with BiV pacing) device might also improve symptoms.

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