Current guideline-directed risk markers for sudden cardiac death in dilated cardiomyopathy have limited effectiveness, prompting exploration of new imaging, electrophysiological, and genetic markers.
Do new imaging, electrophysiological, and genetic risk markers improve sudden cardiac death risk stratification in patients with dilated cardiomyopathy compared to current guideline markers?
This review highlights the limitations of current LVEF and NYHA-based risk stratification for SCD in DCM and explores emerging imaging, electrophysiological, and genetic markers to better identify patients who would benefit from ICD therapy.
Dilated cardiomyopathy (DCM) is a common yet challenging cardiac disease. Great strides have been made in improving DCM prognosis due to heart failure but sudden cardiac death (SCD) due to ventricular arrhythmias remains significant and challenging to predict. High-risk patients can be effectively managed with implantable cardioverter defibrillators (ICDs) but because identification of what is high risk is very limited, many patients unnecessarily experience the morbidity associated with an ICD implant and many others are not identified and have preventable mortality. Current guidelines recommend use of left ventricular ejection fraction and New York Heart Association class as the main markers of risk stratification to identify patients who would be at higher risk of SCD. However, when analysing the data from the trials that these recommendations are based on, the number of patients in whom an ICD delivers appropriate therapy is modest. In order to improve the effectiveness of therapy with an ICD, the patients who are most likely to benefit need to be identified. This review article presents the evidence behind current guideline-directed SCD risk markers and then explores new potential imaging, electrophysiological and genetic risk markers for SCD in DCM.
Pooranachandran et al. (Wed,) conducted a review in Dilated cardiomyopathy. Non-invasive risk markers was evaluated. Current guideline-directed risk markers for sudden cardiac death in dilated cardiomyopathy have limited effectiveness, prompting exploration of new imaging, electrophysiological, and genetic markers.