What would be a reasonable threshold to recommend epicardial CRT-D intra-op in a patient post-ACS with LVEF< 35%, QRS duration > 120, and breakthrough VT undergoing emergent CABG?

In answering this question, one should keep in mind that CRT-D provides 2 primary benefits: resynchronization therapy to treat systolic heart failure in appropriate patients and defibrillation in patients at risk for malignant arrhythmia. We NEVER implant a defibrillator in a patient having active VT; this requires stabilization of the VT first, my revascularization, antiarrhythmics, heart failure optimization, or ablation. In this patient, the medium-term recovery after the acute ACS and revasc...