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Arrhythmic Myocarditis and Prevention of Sudden Cardiac Death: Current Evidence, Risk Stratification, and Management.
Massimo Imazio1, Valentino Collini1, Mariacristina Tomat1
1Department of Medicine, University of Udine, Italy; Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Udine, Italy.
Summary
Myocarditis can cause dangerous heart rhythms and sudden cardiac death (SCD). Early risk identification and personalized treatments are crucial for managing arrhythmic myocarditis.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Myocarditis is myocardial inflammation with varied symptoms.
- Arrhythmic presentations are linked to sudden cardiac death (SCD).
- Ventricular arrhythmias affect ~10% of acute myocarditis patients, often early.
Purpose of the Study:
- To review epidemiology, mechanisms, and risk stratification of SCD in arrhythmic myocarditis.
- To highlight emerging concepts in imaging, genetics, and personalized management.
Main Methods:
- Literature review of contemporary studies on myocarditis and arrhythmias.
- Synthesis of evidence on risk factors, diagnostic tools, and therapeutic strategies.
Main Results:
- Risk stratification involves clinical data, cardiac function, arrhythmias, genetics, and MRI.
- Management includes anti-inflammatory treatment, heart failure therapy, anti-arrhythmics, ablation, and ICDs.
Conclusions:
- Arrhythmic myocarditis poses a significant SCD risk.
- Integrated approaches using advanced imaging and genetics improve risk assessment and personalized care.
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