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30-35% heart function

My father is a 58y BM 145 lbs and a 5'10 height.

Past medical history: He had a mild heart attack at the age of 28, then in 2003 he had an MI with cardiac arrest which resulted in anoxic brain injury (Heart attack, along with a stroke that he suffered around the same time). A CT scan of the head reveals bilateral occipital subacute infarctions He required prolonged hospitalization - 9 months making a slow recovery after being on life support. He did have a MIBI perfusion scan in 2003 and 2004, both of them showed EF of 19%. He had an echocardiogram as well with EF showing in lower range. He didn't recover 100%, motor function, memory, tunnel vision and his personality were severely effected. Nonetheless he is living a healthy life under the care of my mom. In 2003 a couple of months after the heart attack he received a stent. He also received an ICD pacemaker defibrillator at this time and was put on several medications with regular check ups. He hasn't had a heart attack since. He also has a history of hypertension and high cholesterol and hyperlipidemia.

**Two weeks ago my dad collapsed and was admitted to the emergency room after suffering multiple ICD shock. He never lost consciousness completely but there was a near syncopal episode. He then had two episodes of ventricular tachycardia and apparently was treated with antitachycardia pacing. He was symptomatic. He was then started on Amiodarone at 400mg twice daily then lowered to 200mg twice daily in anticipation for discharge. He was then having phantom shocks or could be related to other problems. He was kept in the hospital for one week monitoring him- they diagnosed him with Ventricular Tachycardia Arythmia and put him on the medication Amiodrone. The electrocardiogram showed inferolateral Q waves consistent with his known inferolateral MI. He had an echocardiogram which showed EF of 35% with inferolateral and midseptal akinesia. There is moderate MR. He is having a MIBI test done in a couple of weeks, regular blood tests and ECG. I inquired about an angiogram the specialist is advising that it may be too invasive with difficult recovery at this time and if they did find something aside from stent intervention - he doesn't believe a surgeon would agree to operate. They are monitoring his heart, lungs, kidneys and thyroid function.

My dad exercises daily though his muscle mass has decreased he also eats a very healthy diet- has cut out caffeine and sodium. He has never smoked and does not drink alcohol

Is anyone able to offer insight or suggestions on my dad's health in regards to questions we should be asking, tests that we should be requesting, lifestyle/dietary changes to improve his quality of life, I understand its relative but any idea on how long one lives with this type of heart failure history?
Should we get a referral to a cardiologist for a second opinion as he lives in a small town and the doctors that are involved in his care are mostly internists and there is no cardiologist in the city.

Thank you.
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