Limitations and Possibilities of Noninvasive Risk Stratification for Sudden Cardiac Death

Abstract

Therapy of sudden cardiac death is dominated by the implantable cardioverter defibrillator (ICD), which is highly efficient, but also has side effects. Therefore, the adequate selection of patients who could benefit from this therapy is crucial. For risk stratification, left ventricular ejection fraction is basically used. It has, however, neither a high sensitivity nor a high specificity. Yet, its benefit has been proven in large randomized trials. Numerous noninvasive risk stratification parameters are available and still object of research to achieve a better prediction of sudden cardiac death than actually possible. This article gives an overview of the possibilities of noninvasive risk stratification and shows the concepts and the potential benefit.

Ventricular Arrhythmias: From Risk Assessment for Sudden Cardiac Death to Therapeutic Intervention

“…Current international guidelines base recommendations for the placement of an implantable cardioverter defibrillator (ICD) on quantification of left ventricular function; however, more sensitive and specific predictors of sudden cardiac death are desirable. In this issue of Herz, Tönnis [1] provides a thorough review on the current state of noninvasive parameters and tests utilized for risk stratification of sudden cardiac death in patients with structural heart disease.…”