What disqualifies a patient from receiving an ICD?

A recent history of enzyme-positive myocardial infarction disqualifies a patient from receiving an Implantable Cardioverter Defibrillator (ICD) because it indicates potential ongoing myocardial damage, often leading to unstable heart rhythms and a higher risk of future cardiovascular events. Patients who have experienced an acute myocardial infarction are often in a recovery phase where their heart function is being closely monitored. The eligibility for an ICD typically requires that the patient's condition be stable and that they demonstrate a reduced risk of sudden cardiac death due to arrhythmias following stabilization and optimization of therapy.

In contrast, having hemodynamic stability indicates that the patient has a functioning cardiovascular system, which is a consideration for ICD candidacy. Long-term optimal medical therapy suggests that the patient is well-managed and may not require an ICD if their heart failure is adequately controlled. Family history of arrhythmias might be significant in assessing risk, but it does not negate ICD candidacy on its own. The goal is to balance the need for arrhythmia prevention with ensuring that the patient's overall cardiac condition is stable enough to warrant the device's placement.