Advice for icd

[Gmanral]

Hi,
  I was recently diagnosed with cardiomyopathy with severe biventricular dysfunction three months ago. On cardiac mri, My EF was 30. Lvedd was 7.3 and lveds was 6.5.
Now after three months, with transthoracic echocardiogram  EF is still 25 -30. Lvidd 6.1 cm and lvids 4.96cm. All other measurements are in range. There is no scarring, fibrosis, blockage or stenosis.

My doc advices me to go for icd, I have no symptoms. I haven't started my exercise routine yet. I can walk 2-3 miles at 2mph without any breathlessness.

I am 36 yrs old male, Ten years back I was an athelete, into wrestling, swimming , short put and never had any serious illnesses. Now I am pretty much confined to my computer all day with no excercise.

Do u think there is a risk in waiting for the next three months and watching the EF , in case it goes up by aerobic excersise.


Please advise.
Regards,
GM.

[jrbon]

As far as I understand, if you do not have had fibrillation issues, they should wait 6 months to allow you heart to recover.

If you do not have any arrhythmia, I would wait.

A simple ICD will not do anything for your heart except avoid it to stop in case of V fibrillation.

The only reason why they speak about ICD with you is because below EF of 30% you have more probabilities for a sudden death.

You have to consider your personal, familiar situation and the impact that an ICD could have in your work.

Just remember, I am not a Dr. Just a patient like you.

Jesus

Jesus

[Gmanral]

Thanks Anitha,
      I Have been doing these for some time now, made a lot of changes to lifestyle.
  Today the Bp was 103/73 and heart rate 56 after I came from work . Is this anything to worry about? Could the heart rate get even lower while sleeping and be dangerous? I am on meds to reduce the high Bp and heart rate. The meds I am taking is 50mg carvedilol daily. Lisinopril, asprin.

Also one question I had was , if the lvidd reduced from 7.3 to 6.14 and lvids reduced from 6.5 to 4.96 in three months, aren't there chances that it will get better in next three months. And shouldn't be the EF be more than 30% now! considering with older measurements it was 26%. Even with the new measurements it shows 30, which is confusing.

Thanks for your time and advice, really appreciate it.
Regards,
GM.

[Paderla Anitha, DNB]

Hi, the basic cause for the diminished ejection fraction needs to be treated for the ejection fraction to improve. In your case the cardiomyopathy. Ejection fraction can be improved by lifestyle changes, medications and procedures, such as the insertion of an implantable defibrillator (ICD) is indicated, with an EF of 25-30%.  Lifestyle changes include limiting physical activity, eating a heart healthy diet, completely avoiding alcohol and/or tobacco use, practice relaxation techniques like yoga and keeping a daily weight diary to keep a tab on weight changes. Medications such as digoxin and beta blockers help to improve the pumping capacity of the heart. Discuss these options with your consulting doctor. Regards.