Key result
Noninvasive risk stratification for sudden cardiac death in postinfarction patients relies on multiple markers integrated into Holter software, as no single ideal predictive marker currently exists.
The evolution of Holter technology allows for the integration of multiple noninvasive markers to improve sudden cardiac death risk stratification in postinfarction patients.
Multimarker Holter integration may refine post-MI SCD risk assessment; leaves open prospective validation before clinical adoption.
Sudden cardiac death ( SCD ) threatens ischemic cardiomyopathy patients. Antiarrhythmic protection may be provided to these patients with implanted cardiac defibrillators ( ICD ), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity. Current risk stratification strategies focus on markers that, by identifying the arrhythmic substrate and the severity of the arrhythmia mechanisms present, are also considered to quantify the risk of SCD . Such markers reflect: (1) myocardial substrate lesions and postinfarction fibrosis ( LVEF , QRS , LBBB , SAECG , fragmented QRS , CMR , PVB s, NSVT ), (2) abnormal repolarization ( QT , QT d, T‐wave alternans, QT / RR , QTVI , TWV ), (3) impaired autonomic nervous system function ( HR , heart rate variability ( HRV ), HRT , deceleration capacity ( DC ), BRS , HR recovery after exercise), and (4) inducibility on programmed ventricular stimulation during electrophysiological testing. Ventricular tachyarrhythmias have a strong dynamic component because transient and unpredictable factors can trigger a fatal arrhythmic episode. For this reason, SCD risk stratification is not simple and no ideal marker or a completely successful predictive model is existing. The evolution of technology made possible all the noninvasive markers to be incorporated in the Holter software. Noninvasive risk stratification has been simplified. Innovative Holter technology enforced the doctors, providing them with the tools for primarily screening their patients through the ICD protection process. Answer questions and earn CME : https://wileyhealthlearning.com/Activity2/4469459/Activity.aspx
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Αρσένος et al. (2016) conducted a review in Ischemic cardiomyopathy and postinfarction patients at risk of sudden cardiac death. Noninvasive risk stratification markers was evaluated. Noninvasive risk stratification for sudden cardiac death in postinfarction patients relies on multiple markers integrated into Holter software, as no single ideal predictive marker currently exists.
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