UTILITY OF A MEDICAL OPTIMIZATION CLINIC IN HEART FAILURE PATIENTS WITH AN IMPLANTED CARDIAC DEVICE

BackgroundGuideline-directed medical therapy (GDMT) reduces mortality in patients with heart failure reduced ejection fraction. However, GDMT is not uncommonly de-escalated following implanted cardioverter defibrillator (ICD) implantation. We describe our experience the Device Medical Optimization Clinic (DMOC) at Hamilton Health Sciences, which was established to facilitate optimization cardiac device patients.Methods and ResultsAll who visited DMOC between September 9, 2020, December 22, 2021, were analysed (n=121). Mean age 70.5 (±9.8) years, 77.7% of male. A total 32.2% had ischemic cardiomyopathy, 23.1% hospitalization within previous year, 43.0% a CRT-D. left ventricle fraction 32.4% (± 11.4%). At baseline, 76.9%, 89.3%, 24.8% on an ACE inhibitor/ARB/ARNI, beta blocker, mineralocorticoid receptor antagonist (MRA), respectively. After first visit, use inhibitor/ARB/ARNI increased 85.1%, driven by overall increase ARNI from 27.3% 44.6% (p < 0.001). In addition, 14.9% their dose increased. Use blockers 92.6% (p=0.13), blocker MRAs 34.7% (p=0.0015). An SGLT-2 inhibitor started 14.0% 0.001).Conclusion patients. Guideline-directed Methods All Conclusion