Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 57-64 |
| Number of pages | 8 |
| Journal | Heart Lung and Circulation |
| Volume | 28 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jan 2019 |
Keywords
- Cardiomyopathy
- Implantable cardioverter-defibrillator
- Primary prevention
- Sudden cardiac death
Cite this
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Sudden Death Risk-Stratification in 2018–2019 : The Old and the New. / Zaman, Sarah; Goldberger, Jeffrey J.; Kovoor, Pramesh.
In: Heart Lung and Circulation, Vol. 28, No. 1, 01.01.2019, p. 57-64.Research output: Contribution to journal › Review Article › Other › peer-review
TY - JOUR
T1 - Sudden Death Risk-Stratification in 2018–2019
T2 - The Old and the New
AU - Zaman, Sarah
AU - Goldberger, Jeffrey J.
AU - Kovoor, Pramesh
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Cardiomyopathy
KW - Implantable cardioverter-defibrillator
KW - Primary prevention
KW - Sudden cardiac death
UR - http://www.scopus.com/inward/record.url?scp=85055515130&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2018.08.027
DO - 10.1016/j.hlc.2018.08.027
M3 - Review Article
VL - 28
SP - 57
EP - 64
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
SN - 1443-9506
IS - 1
ER -