what to do next for this man?

A colleague rang me this morning about a 65 year old man. background ischaemic cardiomyopathy -angio last week no targets for revascularisation suitable for a bivent ICD as EF 25% and has lbbb on ecg worsening heart failure - put on 3kg over past 24 hours on furosemide 80mg / 40 mg iv, spironolactone 25mg,  ramipril 2.5mg and bisoprolol 5mg BP 120 systolic, creatinine 110 , sodium now 122 (was normal 1 week ago)   what would you do next? sadian
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums