Hello myflood

First off, my apologies for taking so long to reply to your post. Our house over this long weekend has been filled with visitors and while it is great to have all this company, it is also exhausting. Even our dog is visited-out. She is lying on the sofa, eyes firmly shut and snoring. The last visitor just left this morning and now I can check messages.
It would appear that the combination of medications and exercise have stabilized your EF rate. I, too, was put on Entresto and carvedilol. But, unfortunately for me, they did not prevent my EF rate from dropping more. I am still taking them but now they work much more efficiently because of the CRT-D. Entresto, alone, is an amazing drug. My BP is routinely at 104/70.
I really did not have a choice about the timing of getting a CRT. My EF rate had dropped from 32% to less than 19% in 2.5 months. I was so exhausted, I could not walk 200 feet. I was dizzy most of the time and could not catch my breath. I laid down most of the time, had very little appetite along with profound sense of hopelessness. And, interestingly, considering I was so tired, I also developed insomnia which only made matters worse.
While after the implant my EF rate did start to improve rather quickly, my physical deficiencies – shortness of breath, stamina, overall physical strength, etc. took a while to improve. Indeed, although I have had the CRT since September of 2022, it is only this past summer that I feel I have regained much of what I had loss and am back to my pre-diagnosis levels. But it did require effort and I do some serious exercising each and every day. So, if I were to give any advice on this matter, it would be to say, based on my experience, not to let your condition deteriorate too much before you make the decision. Your physician can guide you on this.
As I have said before on this Forum, I do not think anyone wants one of these devices. I know I didn't. But, quite honestly, I am ever so grateful to live in a time where they are available.
Take care of yourself.