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Minerva Cardioangiologica 2007 June;55(3):379-84

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Risk stratification for sudden death in heart failure

Farwell D., Gollob M. H.

Arrhythmia Research Laboratory University of Ottawa Heart Institute Ottawa, ON, Canada

Clinical trials provide evidence that an empiric approach of implantable cardioverter-defibrillator (ICD) implantation in heart failure patients (ejection fraction ≤ 35%) with mild to moderate symptoms reduces mortality rate as compared to the best available medical therapy. However, ejection fraction alone is unable to predict death by progressive pump failure or sudden arrhythmic death, and consequently over half of all patients will not require device therapy over long-term follow-up. Thus, the approach of empiric ICD implantation results in excessive cost in the absence of more specific risk stratification for sudden death. This review summarizes the current noninvasive risk stratifying strategies available in predicting susceptibility to sudden arrhythmic death in heart failure populations.