@unclefreddy
I am not sure if your question is for me. If you put in your reply the tag for the person you want to directly respond to that will let them know.

If you were asking me. I was diagnosed in 2001 with HF. My EF was going down steadily from 2001 to 2006 to 30. My local cardioloist referred me to a EP (Electrophysiologist) to determine ICD. At that time I decided to go to Mayo Clinic Jacksonville for second opinion.

I met with the Director of Physiology and he recommended not only a ICD but pacemaker to help my heart get the electrical signals. He also referred me to Mayo HF specialist who wanted me on different medications and higher doses. I chose to change my medical care to Mayo Clinic.

I was seen in January 2006 and my ICD/Pacemaker was put in February 2006. I am on my 3rd one now which has another 4 years of battery life.

My ICD has saved my life many times. I have not had any shocks for several years now with new medictions and some programming changes to my pacemaker.

You should be seeing a electrophysiologist (EP) if possible. If not a cardiologist who is expereinced with ICD/Pacemakres.

A EP is the expert in electrical issues of heart, ICDs, Pacemakers, etc. Most cardiologists will referr you to a EP just like my original local cardiologist did that I mentioned above.

You can always have your ICD or Pacemaker, or a dual device like mine, done at a major medical facility like Mayo, Cleveland Clinic, etc., and have your local cardiologist work with the EP who puts in your ICD, paceamker or dual device.

I am not sure about your question but for me I would be seeking a EP for consultation if at all possible. If not a cardiologist who is experienced with ICD/Pacemakers.