TY - JOUR
T1 - Risk of Arrhythmic Death in Patients With Nonischemic Cardiomyopathy
T2 - JACC Review Topic of the Week
AU - Chrispin, Jonathan
AU - Merchant, Faisal M.
AU - Lakdawala, Neal K.
AU - Wu, Katherine C.
AU - Tomaselli, Gordon F.
AU - Navara, Rachita
AU - Torbey, Estelle
AU - Ambardekar, Amrut V.
AU - Kabra, Rajesh
AU - Arbustini, Eloisa
AU - Narula, Jagat
AU - Guglin, Maya
AU - Albert, Christine M.
AU - Chugh, Sumeet S.
AU - Trayanova, Natalia
AU - Cheung, Jim W.
N1 - Publisher Copyright:
© 2023 American College of Cardiology Foundation
PY - 2023/8/22
Y1 - 2023/8/22
N2 - Nonischemic cardiomyopathy (NICM) is common and patients are at significant risk for early mortality secondary to ventricular arrhythmias. Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy to decrease sudden cardiac death (SCD) in patients with heart failure and reduced left ventricular ejection fraction. However, in randomized clinical trials comprised solely of patients with NICM, primary prevention ICDs did not confer significant mortality benefit. Moreover, left ventricular ejection fraction has limited sensitivity and specificity for predicting SCD. Therefore, precise risk stratification algorithms are needed to define those at the highest risk of SCD. This review examines mechanisms of sudden arrhythmic death in patients with NICM, discusses the role of ICD therapy and treatment of heart failure for prevention of SCD in patients with NICM, examines the role of cardiac magnetic resonance imaging and computational modeling for SCD risk stratification, and proposes new strategies to guide future clinical trials on SCD risk assessment in patients with NICM.
AB - Nonischemic cardiomyopathy (NICM) is common and patients are at significant risk for early mortality secondary to ventricular arrhythmias. Current guidelines recommend implantable cardioverter-defibrillator (ICD) therapy to decrease sudden cardiac death (SCD) in patients with heart failure and reduced left ventricular ejection fraction. However, in randomized clinical trials comprised solely of patients with NICM, primary prevention ICDs did not confer significant mortality benefit. Moreover, left ventricular ejection fraction has limited sensitivity and specificity for predicting SCD. Therefore, precise risk stratification algorithms are needed to define those at the highest risk of SCD. This review examines mechanisms of sudden arrhythmic death in patients with NICM, discusses the role of ICD therapy and treatment of heart failure for prevention of SCD in patients with NICM, examines the role of cardiac magnetic resonance imaging and computational modeling for SCD risk stratification, and proposes new strategies to guide future clinical trials on SCD risk assessment in patients with NICM.
KW - cardiac magnetic resonance imaging
KW - computational modeling
KW - nonischemic cardiomyopathy
KW - sudden cardiac death
KW - ventricular arrhythmias
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U2 - 10.1016/j.jacc.2023.05.064
DO - 10.1016/j.jacc.2023.05.064
M3 - Review article
C2 - 37587585
AN - SCOPUS:85167412764
SN - 0735-1097
VL - 82
SP - 735
EP - 747
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 8
ER -