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Underutilization of implantable cardioverter defibrillators post coronary artery bypass grafting in patients with

Jerry M John1, Ahmed Hussein, Naser Imran

  • 1University of Toledo Medical Center, Toledo, Ohio, USA.

Pacing and Clinical Electrophysiology : PACE
|February 26, 2010
PubMed

Insights

Delayed assessment of left ventricular ejection fraction (LVEF) after coronary artery bypass grafting (CABG) may lead to underuse of prophylactic internal cardioverter defibrillators (ICDs) in patients with ischemic cardiomyopathy.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Prophylactic internal cardiac defibrillators (ICDs) are crucial for managing ischemic cardiomyopathies.
  • Evaluation for ICDs should occur at least 3 months post revascularization to assess ventricular function recovery.

Purpose of the Study:

  • To determine the proportion of patients with left ventricular systolic dysfunction (LVSD) undergoing coronary artery bypass grafting (CABG) who have their left ventricular ejection fraction (LVEF) reassessed postoperatively.

Main Methods:

  • Retrospective chart review and telephone contact of 106 patients with LVSD (LVEF < 40%) who underwent CABG between 2004-2006.
  • Assessed LVEF reassessment rates and subsequent referral for prophylactic ICD implantation.

Main Results:

  • LVEF was not reassessed in 24% of patients; none received ICDs.
  • Persistent LVSD was found in 25% of patients with reassessed LVEF.
  • 12 patients with persistent LVSD were referred for ICD placement.

Conclusions:

  • A significant proportion of patients with LVSD post-CABG do not have LVEF reassessed.
  • This oversight may contribute to the underutilization of prophylactic ICDs in eligible patients.
Abstract

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