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Brugada syndrome — RCPSC IM MCQ

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HardCardiologyBrugada syndromeRCPSC IM

A patient with nonischemic dilated cardiomyopathy has LVEF 28% after more than three months of optimized guideline-directed therapy and remains NYHA II. There is no reversible cause and life expectancy is otherwise good. What device discussion is appropriate?

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Correct answer: B — Assess candidacy for a primary-prevention defibrillator

Persistently reduced LVEF despite optimized therapy warrants assessment for primary-prevention ICD according to phenotype and prognosis. A pacemaker alone, indefinite wearable therapy, waiting for arrest, or ablation without arrhythmia does not address standard sudden-death prevention.

Reference: Canadian Cardiovascular Society, 2021 HFrEF guideline: Referral for ICD and CRT: https://ccs.ca/guideline/2021-heart-failure-reduced-ef/chapter-4-referral-for-icd-and-crt/