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- W2110168295 abstract "Implantable cardioverter defibrillator (ICD) has been demonstrated effective in preventing sudden cardiac death in high patients. However, individual prognostic stratification is needed in order to optimise cost-effectiveness ratio. Depressed left ventricular ejection fraction (LVEF) is the most powerful predictor of total mortality and sudden death. In particular, subgroup analysis of ICD trials demonstrated that the patients with very LVEF ( 10/h in the pre-thrombolytic era and > 30/h in the thrombolytic era were associated to significantly increased risk. Ventricular late potentials showed an high negative predictive power, while the positive predictive power was very low. Heart rate variability and baroreflex sensitivity, individually or in combination, significantly discriminated patients at higher or lower risk. However, only inclusion of LVEF in the analysis allowed identification of patients at very high risk. Invasive electrophysiological study com- bined with depressed LVEF and unsustained ventricular tachycardia selected very high patients in MADIT and MUSTT trials. In spite of that, in the MUSTT registry not inducible patients showed a 24 % sudden death rate after 5 years. As a matter of fact, the major challenge for the future is the improvement of sensitivity in patient stratification, considering that the actual number of deaths is higher in the so called low risk groups. J Clin Basic Cardiol 2001; 4: 275-8." @default.
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- W2110168295 date "2001-01-01" @default.
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- W2110168295 title "Controversies in the Prevention of Sudden Death" @default.
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