Sudden Cardiac Death in Patients with Heart Disease and Preserved Systolic Function: Current Options for Risk...

Area of Science:

• Cardiology
• Electrophysiology
• Cardiovascular Medicine

Background:

• Sudden cardiac death (SCD) is a major cause of mortality in coronary artery disease and heart failure with preserved ejection fraction.
• Patients with preserved or mid-range left ventricular ejection fraction (LVEF >35%) experience a higher absolute number of SCDs globally.
• Current guidelines lack specific recommendations for SCD risk reduction in this patient group.

Purpose of the Study:

• To provide a comprehensive overview of current state-of-the-art risk stratification for SCD.
• To identify patients with mid-range or preserved LVEF who may benefit from implantable cardioverter-defibrillator (ICD) implantation.
• To focus on specific etiologies including ischemic cardiomyopathy, heart failure, atrial fibrillation, and myocarditis.

Main Methods:

• Review of existing literature and ongoing advancements in risk stratification techniques.
• Analysis of electrophysiological and imaging modalities for patient identification.
• Focus on evidence-based approaches for SCD prevention.

Main Results:

• Improvements in risk stratification are enhancing the identification of high-risk individuals.
• Electrophysiological and imaging techniques show promise for personalized risk assessment.
• There remains an unmet need for clear guidelines on ICD implantation in this population.

Conclusions:

• Accurate SCD risk stratification is crucial for patients with preserved or mid-range LVEF.
• Advanced techniques are improving the ability to identify candidates for ICD therapy.
• Further research and guideline development are needed to address SCD prevention in this growing patient cohort.