There are many methods of determining the EF, the fast and dirty (cheap and quick) method being an echo. Echo's tend to be somewhat subjective so one person interpretation of the EF might be one number while another might come up with a different number. Echos however are valuable. When conducted by the same person over and over, it gives a quick view of any change in the heart function. There is a tolerance of 10% on echo data.

Other tests are more accurate and provide additional details that may not be visible on an echo, however much is determined by insurance companies as well as availability of test technology.

As to whether they come in higher or lower...yes, they can come in higher or lower. In other words it varies

couple additional thoughts.

I'm the long time proud owner of an ICD and about to step up to the Presidents club and get my very own CRT-D so if you have any questions on these devices let me know

Good luck

I guess all Im looking to do (ever since leaving the hospital one year ago) is avoid the installation of any hardware This is the second Doctor who has suggested Cardiac Resynchronization Therapy (CRT). Im coming to the realization that this may be a great thing. I have to start following the advice of people who know best. Thank you sir

I'm with you, I don't want to become a medical junk scrap yard but there are medical devices that can improve quality of life for those with Congestive Heart Failure. Particularly those with LBBB (Left Bundle Branch Block)

Why the hell do they have to make everything sound so complex? It simply ,means your Ventricles are not beating in synch and by pacing the two chambers simultaneously, they improve the function and force by which the blood is ejected into the body so your EF improves.

I don't want to mislead you, this doesn't work for everyone, but you do need a defibrillator anyway as you are at high risk of sudden cardiac arrest (SCA) with your EF so low, and a tin can probably beats dead. Personally, I'm not afraid of dying, none of us are going to survive life, I'm just not in a rush to enjoy that adventure yet.

Good luck. It's a pretty simple procedure should you choose to do it and should be out and about within a day. It'll hurt and be irritating for a few weeks, but no real big deal.

Oh and they'll tell you to keep your left arm down...what that means is don't raise the elbow above shoulder height, there's a slight risk of dislodging the leads for a few weeks until scar tissue grows over. Just make certain you do use the arm as you don't want frozen shoulder, believe me that's worse than the implant.

RoboPop is right on! My Medtronic Consulta PM was replaced with a Medtronic VIVA PM/ICD this past Jan. A few weeks later, my E.P. performed a optimization where he watched the echo and then told the Device Clinic nurse to adjust my Ventricular timing either + or - milliseconds to get the best EF. Took him about a half hour to get the best result. No other E.P. had ever performed that procedure for me.
Comment made by one nurse to another during the procedure which I overheard: "How can anyone be so smart?" (Referring to my E.P.)
--Dave--