Decision Making for Implantable Cardioverter Defibrillator Implantation

Goldberger, Jeffrey J.; Hendel, Robert C.

doi:10.1161/circimaging.115.004275

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Impaired sympathetic innervation and activity result in heterogeneous electrical conductance, act as arrhythmic substrate, and are linked to increased risk of SCD [87][88][89]. In this context, the norepinephrine analogue meta-iodbenzylguanidine radiolabeled with iodine-123 (123I-mIBG) has been used to measure neuronal integrity with reference to the heart/mediastinum (H/M) uptake ratio [90,91].…”

Section: Single-photon Emission Computed Tomography (Spect)mentioning

confidence: 99%

CMR-Based Risk Stratification of Sudden Cardiac Death and Use of Implantable Cardioverter–Defibrillator in Non-Ischemic Cardiomyopathy

Keil

Chevalier

Kirchhof

et al. 2021

IJMS

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Non-ischemic cardiomyopathy (NICM) is one of the most important entities for arrhythmias and sudden cardiac death (SCD). Previous studies suggest a lower benefit of implantable cardioverter–defibrillator (ICD) therapy in patients with NICM as compared to ischemic cardiomyopathy (ICM). Nevertheless, current guidelines do not differentiate between the two subgroups in recommending ICD implantation. Hence, risk stratification is required to determine the subgroup of patients with NICM who will likely benefit from ICD therapy. Various predictors have been proposed, among others genetic mutations, left-ventricular ejection fraction (LVEF), left-ventricular end-diastolic volume (LVEDD), and T-wave alternans (TWA). In addition to these parameters, cardiovascular magnetic resonance imaging (CMR) has the potential to further improve risk stratification. CMR allows the comprehensive analysis of cardiac function and myocardial tissue composition. A range of CMR parameters have been associated with SCD. Applicable examples include late gadolinium enhancement (LGE), T1 relaxation times, and myocardial strain. This review evaluates the epidemiological aspects of SCD in NICM, the role of CMR for risk stratification, and resulting indications for ICD implantation.

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Section: Single-photon Emission Computed Tomography (Spect)mentioning

confidence: 99%

CMR-Based Risk Stratification of Sudden Cardiac Death and Use of Implantable Cardioverter–Defibrillator in Non-Ischemic Cardiomyopathy

Keil

Chevalier

Kirchhof

et al. 2021

IJMS

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“…The autonomic nervous system is a key determinant of cardiac electrophysiology [72]. Consequently, autonomic dysfunction has been implicated in ventricular arrhythmogenesis, by generating myocardial heterogeneity in conduction and refractory periods [73]. Electrical parameters used as surrogates for autonomic dysfunction include heart rate variation and heart rate turbulence.…”

Section: Autonomic Dysregulationmentioning

confidence: 99%

Sudden Cardiac Death Prediction in Non-ischemic Dilated Cardiomyopathy: a Multiparametric and Dynamic Approach

Hammersley

Halliday

2020

Curr Cardiol Rep

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Purpose of Review Sudden cardiac death is recognised as a devastating consequence of non-ischaemic dilated cardiomyopathy. Although implantable cardiac defibrillators offer protection against some forms of sudden death, the identification of patients in this population most likely to benefit from this therapy remains challenging and controversial. In this review, we evaluate current guidelines and explore established and novel predictors of sudden cardiac death in patients with non-ischaemic dilated cardiomyopathy. Recent Findings Current international guidelines for primary prevention implantable defibrillator therapy do not result in improved longevity for many patients with non-ischemic cardiomyopathy and severe left ventricular dysfunction. More precise methods for identifying higher-risk patients that derive true prognostic benefit from this therapy are required. Summary Dynamic and multi-parametric characterization of myocardial, electrical, serological and genetic substrate offers novel strategies for predicting major arrhythmic risk. Balancing the risk of non-sudden death offers an opportunity to personalize therapy and avoid unnecessary device implantation for those less likely to derive benefit.

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“…Among them, 237 patients experienced VA, with two-year event rates 15% for HMR ≥1.6 and 37% for HMR <1.6 (P<0.01). 58 Additionally, Merlet et al examined only NICM patients, and found that low HMR predicted all-cause mortality and risk of SCD (P<0.0001). 59 MIBG imaging and its association with autonomic dysfunction could provide incremental prognostic value.…”

Section: Accepted Manuscriptmentioning

confidence: 99%