Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy: results of the European Heart Rhythm Association survey

Alessandro Proclemer*, Thorsten Lewalter, Maria Grazia Bongiorni, Jesper Hastrup Nielsen, Laurent Pison, Carina Blomstrom Lundqvist

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The purpose of this EHRA survey was to examine the current clinical practice of screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy with a focus on selection of candidates for implantable cardioverter-defibrillator (ICD) therapy, timing of ICD implantation, and use of non-invasive and invasive diagnostic tests across Europe. A systematic screening programme for sudden cardiac death existed in 19 out of 31 centres (61.3%). Implantation of ICDs according to the inclusion criteria of MADIT-II and SCD-HeFT trials was reported in 30 and 29% of centres, respectively, followed by MADIT-CRT (18%), COMPANION (16%), and combined MADIT and MUSTT (7%) indications. In patients with severe renal impairment, ICD implantation for primary prevention of sudden death was always avoided in 8 centres (33.3%), was not used only if creatinine level was >2.5 mg/dL in 10 centres (32.2%), and in patients with permanent dialysis in 8 centres ( 33.3%). Signal-averaged electrocardiography and heart rate variability were never considered as risk stratification tools in 23 centres (74.2%). Implantation of a loop recorder was performed in patients with borderline indications for ICD therapy in 6 centres (19.4%), for research purposes in 5 (16.1%), and was never performed in 20 (64.5%) centres. In conclusion, the majority of participating European centres have a screening programme for sudden cardiac death and the selection of candidates for ICD therapy was mainly based on the clinical risk stratification and not on non-invasive and invasive diagnostic tests or implantable loop recorder use.
Original languageEnglish
Pages (from-to)1059-1062
JournalEP Europace
Volume15
Issue number7
DOIs
Publication statusPublished - Jul 2013

Keywords

  • EP wire
  • Sudden cardiac death
  • Screening
  • Risk stratification
  • Ischaemic cardiomyopathy
  • Non-ischaemic cardiomyopathy
  • Implantable cardioverter-defibrillator
  • EHRA survey

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