Why the study?
Patients with cardiac amyloidosis face an increased risk of sudden cardiac death, but the role of an implantable cardioverter-defibrillator for primary prevention remains controversial.
Normal endocardial voltage mapping and negative programmed ventricular stimulation in a patient with AL cardiac amyloidosis suggest a small potential arrhythmogenic substrate, questioning the benefit of primary prevention ICDs in this population.
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May support EPS voltage mapping for SCD risk stratification in cardiac amyloidosis; hypothesis-generating and should not yet change practice.
Patients with cardiac amyloidosis (CA) have an increased risk of sudden cardiac death. (SCD). However, the role of an implantable cardioverter-defibrillator in the primary prevention of SCD in this group of patients is still controversial. We present a case with CA with recurrent syncope and non-sustained ventricular tachycardia. In order to further stratify the risk of SCD, an electrophysiological study with endocardial electroanatomic voltage mapping was performed prior to the ICD placement.
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Liżewska-Springer et al. (2021) studied this question.
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