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ICD for heart failure
The most common heart failure cause is coronary artery disease and previous myocardial infarctions. Other than that, I cannot be more specific, although I agree your husband has lived a very healthy lifestyle.
However, it is important to know what the cause is, because it may influence the treatment.
It is not uncommon to advice to have and ICD implanted in patients with a poor heart function (EF<30%), but that should be done as part of other treatments that involve more than just a pacemaker and a beta blocker.
Therefore you need to ask your doctors some questions!
If an ICD is truly needed, it should have been considered when the pacemaker was first implanted. This could have avoided another operation since it doesn't sound anything has changed since.
Hope this helps,
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