Abstract
Given the availability of therapies to prevent SCD due to otherwise fatal ventricular tachyarrhythmias, it is important to differentiate noninvasive risk stratification techniques that enhance the ability to identify SCD from total mortality. The relative ability for each of the described techniques varies, and the optimal way to combine and use these techniques in clinical practice remains unclear. Low LVEF, which is the most widely used test on which ICD intervention is recommended, does not have a particularly high discriminatory ability to identify SCD rather than non-SCD mortality. Although data exist supporting the concept that noninvasive risk stratification techniques may be useful to identify patients with low LVEF who are at low risk for SCD, this requires further testing. There are also data to support the concept that noninvasive risk stratification techniques may be useful to identify patients who do not have low LVEF who nevertheless are at substantial risk for SCD. Because most SCD occurs in this latter group, substantial effort is justified in evaluating, testing, and ultimately implementing risk stratification strategies in this group.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1179-1199 |
| Number of pages | 21 |
| Journal | Journal of the American College of Cardiology |
| Volume | 52 |
| Issue number | 14 |
| DOIs | |
| State | Published - Sep 30 2008 |
Funding
Writing Group Disclosures Writing Group Member Employment Research Grant Other Research Support Speakers' Bureau/Honoraria Ownership Interest Consultant/Advisory Board Other Jeffrey J. Goldberger Northwestern University RELY, Boehringer Ingelheim † ; MADIT-CRT, Boston Scientific † ; FIX-HF-5, Dynamics † ; WBC Trial, St. Jude † Device donations for NIH-sponsored clinical trial (PACE-MI) from Boston Scientific † ; Medtronic † ; St. Jude Medical † None Majority shareholder, Gold T-Tech (start-up medical device company involved in prevention of thromboembolism) ⁎ Director, Path to Improved Risk Stratification (not-for-profit think tank on risk stratification for sudden cardiac death) † Fellowship support from Boston Scientific † ; Medtronic † ; St. Jude Medical † Michael E. Cain University at Buffalo School of Medicine and Biomedical Sciences None None None None Chair, Publications Committee, Heart Rhythm Society ⁎ None Stefan H. Hohnloser Goethe University None None None None None None Alan H. Kadish Northwestern University Medtronic † ; Pfizer † ; St. Jude † None None None Life Watch † None Bradley P. Knight University of Chicago Hospitals Guidant † ; St. Jude † ; Medtronic † None Guidant † ; Medtronic ⁎ ; St. Jude ⁎ None Guidant ⁎ None Michael S. Lauer Cleveland Clinic Foundation None None None None None None Barry J. Maron Minneapolis Heart Institute Foundation Medtronic ⁎ None None None None None Richard L. Page University of Washington None None None None Heart Rhythm Society ⁎ None Rod S. Passman Northwestern Memorial Hospital Medtronic ⁎ None None None None None David Siscovick University of Washington, Seattle None None None None None None William G. Stevenson Brigham & Women's Hospital None None St. Jude Medical ⁎ ; Biosense Webster, Inc ⁎ ; Medtronic Inc ⁎ ; Boston Scientific, Inc ⁎ ; Bard, Inc ⁎ None Biosense Webster, Inc ⁎ ; St. Jude Medical ⁎ None Douglas P. Zipes Indiana University School of Medicine Medtronic † None Medtronic † None Medtronic † None
Keywords
- AHA Scientific Statements
- death, sudden
- risk assessment
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine