Key result
Multimodality cardiac imaging techniques can effectively risk stratify patients with an LVEF >35% for the prediction of sudden cardiac death by visualizing arrhythmogenic substrates, triggers, and modulators.
Why the study?
Most individuals experiencing sudden cardiac death have an LVEF > 35%, whereas primary prevention ICD guidelines require LVEF <= 35%, highlighting the need for improved risk stratification via multimodality imaging.
Does multimodality cardiac imaging improve risk stratification for sudden cardiac death compared to LVEF alone in patients with structural heart disease?
Does multimodality cardiac imaging improve risk stratification for sudden cardiac death compared to LVEF alone in patients with structural heart disease?
Multimodality cardiac imaging offers improved sudden cardiac death risk stratification beyond LVEF alone, particularly for patients with LVEF > 35%, by visualizing arrhythmogenic substrates, triggers, and modulators.
Multimodality imaging may refine SCD risk stratification beyond LVEF; leaves open whether it can guide ICD use in patients with LVEF >35%.
Sudden cardiac death (SCD) can be effectively prevented with the use of implantable cardioverter-defibrillator (ICD). Current guidelines advocate an ICD for primary prevention in the presence of an left ventricular ejection fraction (LVEF) ≤ 35%. The majority of individuals that experience SCD, however, have an LVEF > 35%. Multimodality cardiac imaging has the ability to visualize the three factors responsible for arrhythmia-mediated SCD, namely substrate, trigger and modulator. Advances in cardiac imaging techniques have allowed improved SCD risk stratification, especially in the group of patients with an LVEF > 35%. However, clinical integration of cardiac imaging for SCD risk stratification will require more comparative data between modalities and parameters, as well as evidence of an impact on outcomes. The current review represents an update on the use of multimodality imaging techniques for SCD risk stratification.
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Bijl et al. (2022) conducted a review in Sudden cardiac death risk stratification. Multimodality cardiac imaging vs. LVEF alone was evaluated. Multimodality cardiac imaging techniques can effectively risk stratify patients with an LVEF >35% for the prediction of sudden cardiac death by visualizing arrhythmogenic substrates, triggers, and modulators.
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