Is there a potential role for CMR in deciding appropriateness for ACID placement?

Background It is a class I indication to place AICDs in patients with ischemic or nonischemic cardiomyopathy with a left ventricular ejection fraction (LVEF) ≤ 35%. Most commonly, the need is determined by LVEF measurements on 2-D echo. This practice was utilized prior to cardiac MRI (CMR) establishment as the LVEF “gold standard” modality. Transthoracic echocardiography is still widely employed because of its wide availability and perceived cost savings. This study was designed to compare LVEF by both 2-D and CMR prior to AICD, along with analysis of comparative Medicare reimbursement.