It is currently unknown whether protection with a defibrillator is still warranted in patients who respond to CRT.

Editor-in-Chief
David J. Wilber, MD, FACC

CME Editor
Smit Vasaiwala, MD

Authors
Mehmet K. Aktas, MD
Ilan Goldenberg, MD
Saadia Sherazi, MD, MS

CME Information
Target Audience
JACC Journal CME is intended for physicians who treat patients with cardiovascular disease.

Important Dates
Date of Release: October 21, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: October 20, 2020

Learner Objectives
After reading this article the reader should be able to:

• Identify the risk of ventricular arrhythmia among patients with heart failure who have cardiac resynchronization therapy with defibrillator (CRT-D) devices and improvement in left ventricular ejection fraction.
• Discuss indications for CRT-D implantation.
• Discuss the role of shared decision making among clinicians and patients at the time of device implantation and generator change.

Method of Participation and Claiming Credit
This ACC JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions. 

Requesting AMA PRA Category 1 CME Credit™ and/or MOC or ECME credit for this Activity

To request credit, you must:

1. Read the article for which you wish to receive credit.
2. Answer the self-assessment questions. You need to have achieved a passing score of 70% or better in order for the Evaluation link to become activated. If you did not achieve a passing score, please click on the Posttest link in the left navigation bar and retake the exam.
3. After you complete the Evaluation, click on the Claim Credit button in the left navigation bar.
4. For CME or COP credit, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim.
5. For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
6. For ECME credit, click the Claim button in the row for ECME. Please note that you may only claim once for this activity. Enter your date of birth and click Submit.
7. The page will be updated with the date and time that you claimed your credit.
8. To view your credit, or to print a certificate, please go to ACC.org and navigate to the My Transcript section of My ACC.

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