The patient is a 68-year-old African American male who has well-controlled hypertension, hyperlipidemia (on a statin) and GERD. He has a h/o MI 2 years ago with a reduced ejection fraction (EF) of 30% (i.e. left ventricular dysfunction). His functional status is NYHA Class III CHF. He is on aspirin, Atenolol, and an ACE-Inhibitor at the time of admission. He expresses concern that, given the state of his heart, he will not survive to see his grandson graduate from law school in 3 years. However, he also states that the quality of his life is important to him, specifically he does not wish to spend time in the hospital or live his life if he cannot be active and interact with his family. The cardiologist tells you that the implantation of a cardiac defibrillator can decrease all causes of mortality in these kinds of patients. However, the cardiologist says that ICD have significant costs and risk associated with them. They both turn to you and ask you to gather the current evidence so they can help the patient make a good decision.