Electrophysiologic testing guided risk stratification approach for sudden cardiac death beyond the left ventricular ejection fraction

Core Tip

Core tip: There is a growing need for more effective risk stratification approach in order to detect those post myocardial infarction and dilated cardiomyopathy patients at high risk for sudden cardiac death (SCD) at early or even asymptomatic stage of heart failure with relatively well preserved left ventricular ejection fraction (LVEF). Although in an individual basis the SCD risk is lower among the patient population compared to the one observed among to those with a severely impaired LVEF, epidemiologically there is a large such patient pool at risk in the community. Based on preliminary evidence these patients could be effectively and timely identified by applying a combined electrophysiologic guided approach using non-invasive electrocardiogram-related markers of risk leading to programmed ventricular stimulation testing. Using this approach, we could select those with inducible ventricular tachyarrhythmias as suitable candidates for implantable defibrillator therapy.