Keywords:
Outcomes analysis, MR, Cardiac, Cardiac Assist Devices
Authors:
G. Pontone1, D. Andreini1, A. Solbiati1, M. Guglielmo1, S. Mushtaq1, A. Baggiano1, V. Beltrama1, C. Rota1, A. I. Guaricci2, M. Pepi1; 1Milan/IT, 2Foggia/IT
Purpose
Sudden cardiac death (SCD) is the most common cause of cardiovascular death averaging 300,000 deaths in the United States annually (1).
In most cases,
SCD is caused by ventricular tachycardia (VT) and ventricular fibrillation (2),
warranting effective prevention strategies of these cardiac rhythm abnormalities to lower the morality rate.
In the broad spectrum of cardiovascular diseases,
the most common underlying cause of SCD is coronary artery disease (CAD) (3).
In ischemic cardiomyopathy (ICM),
the presence and extension of scarring and interstitial fibrosis create the substrate for ventricular arrhythmias triggering (4).
A similar pathology,
characterized by myocardial replacement with interstitial and perivascular reactive fibrosis,
seems to be the main cause of SCD even in patients with non-ischemic dilated cardiomyopathy (DCM) (5,6).
Implantable cardioverter-defibrillator (ICD) demonstrated to be the most effective SCD prophylactic strategy adopted for both primary and secondary prevention in these patients (7,8).
Current guidelines provide indications for ICD therapy based on the left ventricular ejection fraction (LVEF) cut-off value and clinical conditions as classified by the New York Heart Association (NYHA) (9).