Selecting Patients With Nonischemic Dilated Cardiomyopathy for ICDs

Strain echocardiography improves prediction of arrhythmic events in ischemic and non-ischemic dilated cardiomyopathy

“…We showed that patients with NICM had a low risk of life threatening VA, particularly when combined with MD < 70 ms, supporting findings from the DANISH study. [6] Nevertheless, some NICM patients have increased risk of VA, as also shown in our study, and risk has been linked to regional fibrosis [21][22][23]. MD has been associated to arrhythmic risk in NICM [12] and to cardiac arrhythmic risk and fibrosis by cardiac magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy.…”

Comparison between renal denervation and metoprolol on the susceptibility of ventricular arrhythmias in rats with myocardial infarction

“…Myocardial fibrosis is an important substrate for reentry VAs genesis. In fact, many clinical studies showed that the level of fibrosis is an independent predictive factor for VAs both in ischemic and non-ischemic cardiomyopathy 22 , 23 . Our previous study demonstrated that RDN reduced electrical storm in cardiomyopathy patient with ICD, which may be associated with fibrosis 24 .…”

Implantable cardioverter‐defibrillator implantation in non‐ischaemic cardiomyopathy: towards individualized risk stratification

“…However, we have seen progress towards approaches with greater precision in the recent European Society of Cardiology guidelines on ventricular arrhythmias that incorporate contemporary research and recommend consideration of an ICD in patients with LVEF <50% and other risk factors such as LGE, high‐risk genetic variants (such as LMNA or FLNC variants), syncope and ventricular tachycardia inducibility 12 . This encourages a more individualized approach to risk estimation that will surely only become more common as our knowledge advances 5 ( Figure ).…”

“…Even though they might have a high short-term risk for SCD, this is counterbalanced by their enhanced risk of non-sudden death from a competing cause, leading to shorter exposure time to risk. 5 This leads to a reduced proportional risk of sudden death and reduced likelihood of gaining quality of life following an appropriate shock. In contrast, younger patients may have a lower annual risk of SCD but with fewer competing comorbidities and a higher long-term cumulative risk, are more likely to benefit from an ICD.…”