| Objective: Analyze the reasons and further improvement measures for patients with heart failure with low ejection fraction that meet the indications of implantable cardioverter defibrillator(ICD)under the current economic and social conditions,and evaluate ICD’s role in preventing low ejection fraction.Efficacy of sudden cardiac death(SCD)in patients with heart failure.Methods: A retrospective analysis of heart failure patients with LVEF ≤35% in the Third Department of Cardiology,the Second Hospital of Hebei Medical University from January 1,2016 to January 1,2019,was classified according to whether ICD/CRT-D was implanted Treatment group and control group.The basic information of patients,laboratory examinations and treatment data were collected by consulting the hospitalized medical records,and the reasons for the patients in the control group not being implanted with ICDs were clarified through medical records and telephone follow-up.Proportion of patients admitted to ICD;the survival status of patients was obtained through telephone follow-up,with all-cause death or follow-up deadline(January 1,2021)as the observation endpoint,and Kaplan-Meier method was used for survival analysis,Log-rank Test and compare survival curves to study the effect of ICD implantation on the prognosis of patients with chronic heart failure who meet the indications for ICD implantation.Results: 1.A total of 98 patients were enrolled,95 patients completed the follow-up,3 patients were lost to follow-up,and the loss to follow-up rate was3.1%.For the 95 patients who completed the follow-up,the median follow-up time was 39(3-59)months.Patients were divided into treatment group and control group according to whether or not ICD/CRT-D was implanted.There were 27 patients in the treatment group and 68 patients in the control group.The overall ICD/CRT-D implantation rate was 28.4%.In the treatment group,16 patients(59.3%)met the ICD secondary prevention indications,11 patients(40.7%)met the ICD primary prevention indications;23 patients(33.8%)met the ICD secondary prevention indications in the control group There were 45patients(66.2%)who met the ICD primary prevention indications.The treatment group of patients who met the ICD secondary prevention indications was more than the control group.The treatment group of patients who met the ICD primary prevention indications was less than the control group.The difference was statistically Meaning(P=0.023).Based on the same optimized treatment of heart failure,the use rate of the antiarrhythmic drug amiodarone in the treatment group(96.3%)was significantly higher than that in the control group(30.9%),and the difference was statistically significant(P<0.001).There were no statistically significant differences in the age,gender,and admission cardiac function classification(NYHA)of the two groups of patients(P>0.05).2.Through the medical record system and telephone follow-up,the reasons for not implanting ICD are mainly divided into two categories: the doctor in charge did not recommend the ICD treatment plan and the patient did not accept the recommendation.For patients who meet the ICD primary prevention indications,the implantation rate is 19.6%.The physician in charge did not recommend ICD treatment options accounted for 51.8%,and the patients who did not accept the recommendation accounted for 28.6%;for the patients who meet the ICD secondary prevention indications,the implantation rate It was 41%.The doctor in charge did not recommend an ICD treatment plan accounted for 7.7%,and the patient did not accept it after the recommendation accounted for 51.3%.For patients who meet the ICD primary prevention indications,the physician’s recommendation rate is low and the patient’s implantation rate is low.For patients who meet the ICD secondary prevention indications,the physician’s recommendation rate is high and the patient’s implantation rate is high.3.Among the patients who completed the follow-up,56 patients met the ICD primary prevention indications,11 patients(19.6%)in the treatment group,and 45 patients(80.4%)in the control group.The 1-year mortality rate in the treatment group and the control group were 0.0% and 6.7%,respectively(P=0.386),and the 1-year mortality rate in the treatment group was 6.7%lower than the control group;the 2-year mortality rate was 9.1% and 11.1%,respectively(P=0.827)),the two-year mortality rate of the treatment group was 2.0% lower than that of the control group.4.Among the patients who completed the follow-up,39 patients met the ICD secondary prevention indications,16 patients(41.0%)in the treatment group,and 23 patients(59.0%)in the control group.The 1-year mortality rate of the treatment group and the control group were 12.5% and 17.4%,respectively(P=0.660).The 1-year mortality rate of the treatment group was4.9% lower than that of the control group;the 2-year mortality rate was 18.8%and 26.1%,respectively(P=0.574),the two-year mortality rate of the treatment group was 7.3% lower than that of the control group.Conclusion:1.For patients with heart failure who have indications for ICD implantation,the overall ICD implantation rate is low.The reasons for non-implantation are divided into two categories: the doctor in charge did not recommend the ICD treatment plan and the patient did not accept the recommendation.For patients with primary prevention indications,the physician’s recommendation rate is low and the patient’s implantation rate is low.In order to improve the survival rate of patients,great attention should be paid to the recommendations and acceptance of ICD primary prevention.2.The results of the study show that for patients with chronic heart failure who meet ICD primary prevention and secondary prevention,the implantation of ICD has a tendency to reduce the mortality of these patients,but it has not reached statistical significance.It may be necessary to further expand the number of cases and the study.Follow-up 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