Stratifying patients suitable for ICD in heart failure

Heart failure (HF) is a frequently encounter condition in the pharmacy that requires treatment to be individualised depending on the presenting symptoms. Chronic heart failure (CHF) involves both mechanical failure and autonomic nervous system dysfunction which can lead to sudden cardiac death (SCD). A number of therapies are utilised including pharmaceutical and device options; for example the implantable cardioverter/defibrillator (ICD) device. A decision to use an ICD is based on CHF patients presenting with a New York Heart Association (NYHA) classification of IIor III and a left ventricular ejection fraction (LVEF) less than or equal to 35%. A large percentage of ICD devices, however, never deliver therapy during their lifetime while as many as 33% of patients ineligible for an ICD (LVEF > 35%) die of SCD.