DCM_Review-Clean.docx (71.2 kB)
Non-invasive markers for sudden cardiac death risk stratification in dilated cardiomyopathy
journal contribution
posted on 2022-02-10, 10:54 authored by Vivetha Pooranachandran, Will Nicolson, Zakariyya Vali, Xin Li, G Andre NgDilated cardiomyopathy (DCM) is a common yet challenging cardiac disease. Great strides have been made in improving DCM prognosis due to heart failure but sudden cardiac death (SCD) due to ventricular arrhythmias remains significant and challenging to predict. High-risk patients can be effectively managed with implantable cardioverter defibrillators (ICDs) but because identification of what is high risk is very limited, many patients unnecessarily experience the morbidity associated with an ICD implant and many others are not identified and have preventable mortality. Current guidelines recommend use of left ventricular ejection fraction and New York Heart Association class as the main markers of risk stratification to identify patients who would be at higher risk of SCD. However, when analysing the data from the trials that these recommendations are based on, the number of patients in whom an ICD delivers appropriate therapy is modest. In order to improve the effectiveness of therapy with an ICD, the patients who are most likely to benefit need to be identified. This review article presents the evidence behind current guideline-directed SCD risk markers and then explores new potential imaging, electrophysiological and genetic risk markers for SCD in DCM.
History
Citation
Heart, 2021, http://dx.doi.org/10.1136/heartjnl-2021-319971Author affiliation
Department of Cardiovascular Sciences, University of LeicesterVersion
- AM (Accepted Manuscript)
Published in
HEARTPublisher
BMJ Publishing Groupissn
1355-6037eissn
1468-201XAcceptance date
2021-09-23Copyright date
2021Available date
2022-02-10Publisher DOI
Language
EnglishPublisher version
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Keywords
Science & TechnologyLife Sciences & BiomedicineCardiac & Cardiovascular SystemsCardiovascular System & CardiologycardiomyopathydilatedarrhythmiascardiacelectrocardiographydefibrillatorsimplantableT-WAVE ALTERNANSVENTRICULAR-ARRHYTHMIASHEART-FAILUREDEFIBRILLATOR IMPLANTATIONSYSTOLIC DYSFUNCTIONQRSTRIALMAGNETOCARDIOGRAPHYMETAANALYSISVARIABILITY