Optimal Medical Therapy Use Among Patients Receiving Implantable Cardioverter/Defibrillators

Abstract

Current guidelines predicate primary prevention cardioverter/defibrillator (ICD) implantation on patients receiving “optimal medical therapy” (OMT), defined as use of both β-blocker and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) in the absence of contraindications.¹ These recommendations promote clinical optimization of patients with low left ventricular ejection fraction (LVEF) as well as cost-effective allocation of high-cost device therapy. While prior studies hint at significant care gaps among select ICD recipients,² the ICD Registry offered the opportunity to examine national patterns of OMT use among first-time ICD recipients in contemporary, real-world practice.