Key result
The provided text contains only headers and footers, with no extractable clinical data or findings.
Why the study?
What are the current and emerging risk stratification tools for predicting sudden cardiac death to guide prophylactic ICD implantation?
What are the current and emerging risk stratification tools for predicting sudden cardiac death to guide prophylactic ICD implantation?
LVEF is insufficient for SCD risk stratification, highlighting the need for novel combinations of electrophysiological, imaging, and biological markers to better select patients for primary prevention ICDs.
LVEF inadequacy for prophylactic ICD selection in cardiomyopathy leaves open need for validated alternative risk stratification tools.
Sudden Cardiac Death (SCD) is a major public health issue, accounting for half of all cardiovascular deaths world-wide. The implantable cardioverter-defibrillator (ICD) has been solidified as the cornerstone therapy in primary prevention of SCD in ischaemic and non-ischaemic cardiomyopathy. However, what has become increasingly clear is that the left ventricular ejection fraction (LVEF) is an inadequate tool to select patients for a prophylactic ICD, despite its widespread use for this purpose. Use of LVEF alone has poor specificity for arrhythmic versus non-arrhythmic death. In addition, the vast majority of sudden deaths occur in patients with more preserved cardiac function. Alternate predictors of sudden death include electrophysiology study, non-invasive markers of electrical instability, myocardial fibrosis, genetic and bio-markers. The challenge for the future is finding a risk stratification test, or combination of tests, that adequately select patients at high risk of SCD with low competing risk of non-sudden death.
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Zaman et al. (2018) conducted a review in Sudden Death. The provided text contains only headers and footers, with no extractable clinical data or findings.
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