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Clinical Crossroads Update
July 1, 2009

Update: A 59-Year-Old Man Considering Implantation of a Cardiac Defibrillator

JAMA. 2009;302(1):81. doi:10.1001/jama.2009.941

In a Clinical Crossroads article published in May 2007,1 Peter Zimetbaum, MD, discussed the case of Mr M, a 59-year-old man considering an implantable cardioverter-defibrillator (ICD) after experiencing a series of serious cardiac events. Beginning in 2000, Mr M had an acute anterior myocardial infarction; he was treated successfully with thrombolytics. Subsequently, Mr M underwent cardiac catheterization, revealing a lesion of the proximal left anterior descending coronary artery, which was then treated with a stent across the lesion. In addition, a post–myocardial infarction echocardiogram revealed congestive heart failure with a left ventricular ejection fraction of 25%.