Sudden Death Risk-Stratification in 2018–2019: The Old and the New

Sarah Zaman, Jeffrey Goldberger, Pramesh Kovoor

Research output: Contribution to journalReview article

5 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)57-64
Number of pages8
JournalHeart Lung and Circulation
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Sudden Cardiac Death
Sudden Death
Implantable Defibrillators
Stroke Volume
Electrophysiology
Primary Prevention
Cardiomyopathies
Genetic Markers
Fibrosis
Public Health
Therapeutics

Keywords

  • Cardiomyopathy
  • Implantable cardioverter-defibrillator
  • Primary prevention
  • Sudden cardiac death

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Sudden Death Risk-Stratification in 2018–2019 : The Old and the New. / Zaman, Sarah; Goldberger, Jeffrey; Kovoor, Pramesh.

In: Heart Lung and Circulation, Vol. 28, No. 1, 01.01.2019, p. 57-64.

Research output: Contribution to journalReview article

@article{95fbeacd961348bbb83deccf35b76ca9,
title = "Sudden Death Risk-Stratification in 2018–2019: The Old and the New",
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.",
keywords = "Cardiomyopathy, Implantable cardioverter-defibrillator, Primary prevention, Sudden cardiac death",
author = "Sarah Zaman and Jeffrey Goldberger and Pramesh Kovoor",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.hlc.2018.08.027",
language = "English (US)",
volume = "28",
pages = "57--64",
journal = "Heart Lung and Circulation",
issn = "1443-9506",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Sudden Death Risk-Stratification in 2018–2019

T2 - The Old and the New

AU - Zaman, Sarah

AU - Goldberger, Jeffrey

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

UR - http://www.scopus.com/inward/citedby.url?scp=85055515130&partnerID=8YFLogxK

U2 - 10.1016/j.hlc.2018.08.027

DO - 10.1016/j.hlc.2018.08.027

M3 - Review article

C2 - 30482684

AN - SCOPUS:85055515130

VL - 28

SP - 57

EP - 64

JO - Heart Lung and Circulation

JF - Heart Lung and Circulation

SN - 1443-9506

IS - 1

ER -