Title:
Arrhythmic risk stratification in ischemic, non-ischemic and hypertrophic cardiomyopathy: A two-step multifactorial, electrophysiology study inclusive approach
Languages of Item:
English
Abstract:
Annual arrhythmic sudden cardiac death ranges from 0.6% to 4% in ischemic cardiomyopathy (ICM), 1% to 2% in non-ischemic cardiomyopathy (NICM), and 1% in hypertrophic cardiomyopathy (HCM). Towards a more effective arrhythmic risk stratification (ARS) we hereby present a two-step ARS with the usage of seven non-invasive risk factors: Late potentials presence (≥ 2/3 positive criteria), premature ventricular contractions (≥ 30/h), non-sustained ventricular tachycardia (≥ 1episode/24 h), abnormal heart rate turbulence (onset ≥ 0% and slope ≤ 2.5 ms) and reduced deceleration capacity (≤ 4.5 ms), abnormal T wave alternans (≥ 65μV), decreased heart rate variability (SDNN < 70ms), and prolonged QTc interval (> 440 ms in males and > 450 ms in females) which reflect the arrhythmogenic mechanisms for the selection of the intermediate arrhythmic risk patients in the first step. In the second step, these intermediate-risk patients undergo a programmed ventricular stimulation (PVS) for the detection of inducible, truly high-risk ICM and NICM patients, who will benefit from an implantable cardioverter defibrillator. For HCM patients, we also suggest the incorporation of the PVS either for the low HCM Risk-score patients or for the patients with one traditional risk factor in order to improve the inadequate sensitivity of the former and the low specificity of the latter. © 2022 Baishideng Publishing Group Co. All rights reserved.
Authors:
Arsenos, P.
Gatzoulis, K.A.
Tsiachris, D.
Dilaveris, P.
Sideris, S.
Sotiropoulos, I.
Archontakis, S.
Antoniou, C.-K.
Kordalis, A.
Skiadas, I.
Toutouzas, K.
Vlachopoulos, C.
Tousoulis, D.
Tsioufis, K.
Journal:
WORLD JOURNAL OF CARDIOLOGY
Publisher:
BAISHIDENG PUBLISHING GROUP INC
Official URL (Publisher):
DOI:
10.4330/wjc.v14.i3.139
