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Question:

Why is there a 3 month waiting period for an ICD for people in heart failure?

I understand the variability from person to person in regards to CHF. My father was diagnosed with CHF. He has an external defibrillator on. He has 20% heart function and the angiogram showed no blockages in his arteries but apparently showed the dye in other locations of his heart. He is currently on medicine (ACE, beta blockers, diuretics, insulin). The cardiologist indicated there is a 3 month waiting period for an ICD. The cardiologist has not recommended any other testing or treatment. Is the ICD a last resort treatment? Based on past cases, what is the long term prognosis/life expectancy after an ICD is implanted? How critical is diet and exercise for this type of situation? Will the stage of heart failure provide some of my answers?

Submitted by Machel from Texas on 05/14/2014

Answer:
by Reynolds M. Delgado, MD

Essentially it is correct that Medicare requires 3 months to pass after initial diagnosis if heart failure before ICD implant. It is not really a waiting period, but rather based on the studies that some patients will improve enough with just meds after 3 months and thus not need ICD. It is a good idea to wear an external defibrillator, though, as the patient is doing. As to prognosis and therapy, options vary widely based on age and comorbid illnesses, and may include transplant or LVAD. Best to see a cardiologist who specializes in heart failure.