This protocol targets a specific high-risk presentation: patients with dilated cardiomyopathy who remain symptomatic with a left ventricular ejection fraction (LVEF) of 35% or below after more than three months of optimal medical therapy.
Dilated cardiomyopathy with symptomatic heart failure and a left ventricular ejection fraction (LVEF) ≤35%, persisting despite more than 3 months of optimal medical therapy. The combination of an persistently reduced LVEF and ongoing symptoms in this setting defines a population at elevated risk that warrants a specific intervention beyond medical optimisation alone.
For patients meeting these criteria, current evidence supports consideration of a device-based intervention to address the risks associated with a severely reduced ejection fraction. The complete protocol specifies the intervention, applicable clinical thresholds, and implementation guidance.
An ICD should be considered to reduce the risk of sudden death and all-cause mortality in patients with DCM, symptomatic heart failure, and LVEF ≤35% despite >3 months of OMT.
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