Improving the appropriateness of sudden arrhythmic death primary prevention by implantable cardioverter-defibrillator therapy in patients with low left ventricular ejection fraction. Point of view.

Journal of Cardiovascular Medicine
Marcello DisertoriLuigi Tavazzi

Abstract

It is generally accepted that the current guidelines for the primary prevention of sudden arrhythmic death, which are based on ejection fraction, do not allow the optimal selection of patients with low left ventricular ejection fraction of ischemic and nonischemic etiology for implantation of a cardioverter-defibrillator. Ejection fraction alone is limited in both sensitivity and specificity. An analysis of the risk of sudden arrhythmic death with a combination of multiple tests (ejection fraction associated with one or more arrhythmic risk markers) could partially compensate for these limitations. We propose a polyparametric approach for defining the risk of sudden arrhythmic death using ejection fraction in combination with other clinical and arrhythmic risk markers (i.e. late gadolinium enhancement cardiac magnetic resonance, T-wave alternans, programmed ventricular stimulation, autonomic tone, and genetic testing) that have been validated in nonrandomized trials. In this article, we examine these approaches to identify three subsets of patients who cannot be comprehensively assessed by the current guidelines: patients with ejection fraction of 35% or less and a relatively low risk of sudden arrhythmic death despite the ejec...Continue Reading

References

Dec 12, 2001·Journal of the American College of Cardiology·J J BaileyM Hodges
Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
Mar 12, 2003·Journal of the American College of Cardiology·Matthew R G TaylorUNKNOWN Familial Dilated Cardiomyopathy Registry Research Group
Jan 22, 2005·The New England Journal of Medicine·Gust H BardyUNKNOWN Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators
Apr 6, 2005·Journal of the American College of Cardiology·David BelloJeffrey J Goldberger
Jul 5, 2005·Journal of the American College of Cardiology·Anil K GehiJ Anthony Gomes
Jan 13, 2006·The New England Journal of Medicine·Christophe MeuneDenis Duboc
Nov 23, 2006·Journal of the American College of Cardiology·Ravi G AssomullDudley J Pennell
Sep 18, 2007·Journal of the American College of Cardiology·Alfred E BuxtonUNKNOWN MUSTT Investigators
Oct 20, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gaetano M De FerrariMaurizio Landolina
Nov 6, 2007·Journal of the American College of Cardiology·Jorge A Salerno-UriarteUNKNOWN ALPHA Study Group Investigators
Dec 11, 2007·Journal of the American College of Cardiology·Derek V ExnerUNKNOWN REFINE Investigators
Sep 23, 2008·Journal of the American College of Cardiology·Roderick TungMark E Josephson
Oct 18, 2008·Journal of the American College of Cardiology·Michele PasottiEloisa Arbustini
Feb 7, 2009·Journal of the American College of Cardiology·Otto CostantiniUNKNOWN ABCD Trial Investigators
Mar 4, 2009·Journal of Cardiac Failure·Ray E HershbergerUNKNOWN Heart Failure Society of America
Jun 6, 2009·Journal of Cardiovascular Electrophysiology·Alan H KadishJeffrey J Goldberger
Feb 5, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Heikki V HuikuriUNKNOWN CARISMA and REFINE Investigators
Apr 14, 2010·Journal of Cardiovascular Electrophysiology·Paul S ChanBrahmajee K Nallamothu
Oct 27, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Dominic A M J TheunsLuc Jordaens
Jun 3, 2011·Circulation·Jeffrey J GoldbergerDouglas P Zipes
Oct 1, 2011·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Satoshi ShizutaUNKNOWN PREVENT-SCD Investigators
Oct 20, 2011·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Leonardo CalòErnesto Lioy
Oct 26, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Violeta MonasterioJuan Pablo Martínez
Dec 2, 2011·International Journal of Cardiology·Michele SenniAntonello Gavazzi
Jan 28, 2012·Journal of the American College of Cardiology·Ingrid A W van RijsingenYigal M Pinto
Mar 13, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Faisal M MerchantAntonis A Armoundas
May 9, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Juan Fernández-ArmentaJosep Brugada

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Citations

Jul 28, 2019·Heart Failure Reviews·Domenico CorradoEdoardo Gronda
Jul 13, 2017·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Alejandro Velasco, Harish Doppalapudi
Mar 4, 2021·Journal of Clinical Medicine·Arjan SammaniAnneline S J M Te Riele

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Methods Mentioned

BETA
genotyping

Clinical Trials Mentioned

NCT00673842

Software Mentioned

MUSTT
ANMCO

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