Why the study?
Less is known regarding the cause of sudden cardiac death in patients at the upper end of the heart failure spectrum, despite most out-of-hospital victims having unknown or near-normal/normal LVEF.
This review highlights the underrecognized risk of sudden arrhythmic death in heart failure patients with preserved or mildly reduced ejection fraction and proposes a stepwise approach for its prevention.
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Raises awareness of arrhythmic risk in HF with preserved LVEF; leaves open validation of the proposed stepwise prevention approach.
The risk of sudden cardiac death (SCD) is high in heart failure (HF) patients. Sudden arrhythmic death (SAD) is a frequent cause of exit in HF patients at the lower end of the HF spectrum, and implantable cardioverter-defibrillators have been recommended to prevent these life-threatening rhythm disturbances in select patients. However, less is known regarding the cause of SCD in patients at the upper end of the HF spectrum, despite the fact that the majority of out-of-hospital SCD victims have unknown or near-normal/normal left ventricular ejection fraction (LVEF). In this review, we report the epidemiology, summarize the mechanisms, discuss the diagnostic challenges, and propose a stepwise approach for the prevention of SAD in HF with near-normal/normal LVEF.
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Dimos et al. (2019) studied this question.
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