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Open Access 08-04-2024 | Sudden Cardiac Death | Original Paper

Evaluating the predictive value of late gadolinium enhancement assessed by cardiac magnetic resonance on sudden cardiac death in patients selected for implantable cardioverter defibrillator and cardiac resynchronization therapy implantation: a systematic review and meta-analysis

Authors: Richárd Masszi, Előd-János Zsigmond, Réka Ehrenberger, Caner Turan, Péter Fehérvári, Brigitta Teutsch, Zsolt Molnár, Zsófia Drobni, Hajnalka Vágó, Péter Hegyi, Béla Merkely, Annamária Kosztin

Published in: Clinical Research in Cardiology

Abstract

Aims

Late gadolinium enhancement (LGE) assessed by cardiovascular magnetic resonance (CMR) can evaluate myocardial scar associated with a higher risk of sudden cardiac death (SCD), which can guide the selection between cardiac resynchronization therapy with or without a defibrillator (CRT-P/CRT-D). Our aim was to investigate the association between LGE and SCD risk in patients with CRT using the LGE-CMR technique.

Methods and results

We performed a systematic literature search using four databases. The target population was CRT candidates. The primary endpoint was SCD. The risk of bias was assessed using the QUIPS tool.

Fifteen eligible articles were included with a total of 2494 patients, of whom 27%, 56%, and 19% had an implantable cardioverter defibrillator (ICD), CRT-D, and CRT-P, respectively. Altogether, 54.71% of the cohort was LGE positive, who had a 72% higher risk for SCD (HR 1.72; 95% CI 1.18–2.50) compared to LGE negatives. In non-ischemic patients, the proportion of LGE positivity was 46.6%, with a significantly higher risk for SCD as compared to LGE negatives (HR 2.42; 95% CI 1.99–2.94). The subgroup of CRT-only patients showed no difference between the LGE-positive vs. negative candidates (HR 1.17; 95% CI 0.82–1.68). Comparable SCD risk was observed between articles with short- (OR 7.47; 95% CI 0.54–103.12) vs. long-term (OR 6.15; 95% CI 0.96–39.45) follow-up time.

Conclusion

LGE-CMR positivity was associated with an increased SCD risk; however, in CRT candidates, the difference in risk reduction between LGE positive vs. negative patients was statistically not significant, suggesting a role of reverse remodeling. LGE-CMR before device implantation could be crucial in identifying high-risk patients even in non-ischemic etiology.

Graphical abstract

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Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, Estes NA 3rd, Foster E, Greenberg H, Higgins SL, Pfeffer MA, Solomon SD, Wilber D, Zareba W, MADIT-CRT Trial Investigators (2009) Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 361(14):1329–38. https://doi.org/10.1056/NEJMoa0906431CrossRefPubMed

Taylor CJ, Ordóñez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, Hobbs FDR (2019) Trends in survival after a diagnosis of heart failure in the United Kingdom 2000–2017: population based cohort study. BMJ 13(364):l223. https://doi.org/10.1136/bmj.l223CrossRef

Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JGF, Dargie HJ, Granger CB, Kjekshus J, Køber L, Latini R, Maggioni AP, Packer M, Pitt B, Solomon SD, Swedberg K, Tavazzi L, Wikstrand J, Zannad F, Zile MR, McMurray JJV (2017) Declining risk of sudden death in heart failure. N Engl J Med 377(1):41–51. https://doi.org/10.1056/NEJMoa1609758CrossRefPubMed

Tomaselli GF, Zipes DP (2004) What causes sudden death in heart failure? Circ Res 95(8):754–63. https://doi.org/10.1161/01.RES.0000145047.14691.dbCrossRefPubMed

Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L (2005) Cardiac Resynchronization-Heart Failure (CARE-HF) study investigators. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352(15):1539–49. https://doi.org/10.1056/NEJMoa050496CrossRefPubMed

Barletta V, Fabiani I, Lorenzo C, Nicastro I, Bello VD (2014) sudden cardiac death: a review focused on cardiovascular imaging. J Cardiovasc Echogr 24(2):41–51. https://doi.org/10.4103/2211-4122.135611CrossRefPubMedPubMedCentral

Karamitsos TD, Arvanitaki A, Karvounis H, Neubauer S, Ferreira VM (2020) Myocardial tissue characterization and fibrosis by imaging. JACC Cardiovasc Imaging 13(5):1221–1234. https://doi.org/10.1016/j.jcmg.2019.06.030CrossRefPubMed

Glikson M, Nielsen JC, Kronborg MB et al (2021) ESC Scientific Document Group. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 42(35):3427–3520. https://doi.org/10.1093/eurheartj/ehab364CrossRefPubMed

Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, Bezzina CR, Biagini E, Blom NA, de Boer RA, De Winter T, Elliott PM, Flather M, Garcia-Pavia P, Haugaa KH, Ingles J, Jurcut RO, Klaassen S, Limongelli G, Loeys B, Mogensen J, Olivotto I, Pantazis A, Sharma S, Van Tintelen JP, Ware JS, Kaski JP, ESC Scientific Document Group (2023) 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J 44(37):3503–3626. https://doi.org/10.1093/eurheartj/ehad194CrossRefPubMed

10.

Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 29(372):n71. https://doi.org/10.1136/bmj.n71CrossRef

11.

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan-a web and mobile app for systematic reviews. Syst Rev 5(1):210. https://doi.org/10.1186/s13643-016-0384-4CrossRefPubMedPubMedCentral

12.

Schünemann HJ, Oxman AD, Brozek J, Glasziou P, Jaeschke R, Vist GE, Williams JW Jr, Kunz R, Craig J, Montori VM, Bossuyt P, Guyatt GH (2008) GRADE Working Group. Grading quality of evidence and strength of recommendations for diagnostic tests and strategies. BMJ. 336(7653):1106–10. https://doi.org/10.1136/bmj.39500.677199.AE

13.

Austin PC, Lee DS, Fine JP (2016) Introduction to the analysis of survival data in the presence of competing risks. Circulation 133(6):601–9. https://doi.org/10.1161/CIRCULATIONAHA.115.017719CrossRefPubMedPubMedCentral

14.

DominicMagirr 2020 https://dominicmagirr.github.io/post/shiny-app-for-enhancing-published-kaplan-meier-plots/

15.

Piers SR, Everaerts K, van der Geest RJ, Hazebroek MR, Siebelink HM, Pison LA, Schalij MJ, Bekkers SC, Heymans S, Zeppenfeld K (2015) Myocardial scar predicts monomorphic ventricular tachycardia but not polymorphic ventricular tachycardia or ventricular fibrillation in nonischemic dilated cardiomyopathy. Heart Rhythm 12(10):2106–14. https://doi.org/10.1016/j.hrthm.2015.05.026CrossRefPubMed

16.

Fernández-Armenta J, Berruezo A, Mont L, Sitges M, Andreu D, Silva E, Ortiz-Pérez JT, Tolosana JM, de Caralt TM, Perea RJ, Calvo N, Trucco E, Borràs R, Matas M, Brugada J (2012) Use of myocardial scar characterization to predict ventricular arrhythmia in cardiac resynchronization therapy. Europace 14(11):1578–86. https://doi.org/10.1093/europace/eus104CrossRefPubMed

17.

Gao P, Yee R, Gula L, Krahn AD, Skanes A, Leong-Sit P, Klein GJ, Stirrat J, Fine N, Pallaveshi L, Wisenberg G, Thompson TR, Prato F, Drangova M, White JA (2012) Prediction of arrhythmic events in ischemic and dilated cardiomyopathy patients referred for implantable cardiac defibrillator: evaluation of multiple scar quantification measures for late gadolinium enhancement magnetic resonance imaging. Circ Cardiovasc Imaging 5(4):448–56. https://doi.org/10.1161/CIRCIMAGING.111.971549CrossRefPubMed

18.

Fabregat-Andrés O, García-González P, Valle-Muñoz A, Estornell-Erill J, Pérez-Boscá L, Palanca-Gil V, Payá-Serrano R, Quesada-Dorador A, Morell S, Ridocci-Soriano F (2014) Clinical benefit of cardiac resynchronization therapy with a defibrillator in patients with an ejection fraction > 35% estimated by cardiac magnetic resonance. Rev Esp Cardiol (Engl Ed) 67(2):107–13. https://doi.org/10.1016/j.rec.2013.06.016CrossRefPubMed

19.

Acosta J, Fernández-Armenta J, Borràs R, Anguera I, Bisbal F, Martí-Almor J, Tolosana JM, Penela D, Andreu D, Soto-Iglesias D, Evertz R, Matiello M, Alonso C, Villuendas R, de Caralt TM, Perea RJ, Ortiz JT, Bosch X, Serra L, Planes X, Greiser A, Ekinci O, Lasalvia L, Mont L, Berruezo A (2018) Scar characterization to predict life-threatening arrhythmic events and sudden cardiac death in patients with cardiac resynchronization therapy: the GAUDI-CRT study. JACC Cardiovasc Imaging 11(4):561–572. https://doi.org/10.1016/j.jcmg.2017.04.021CrossRefPubMed

20.

Barison A, Chiappino S, Masci PG, Srebot V, Mirizzi G, Pastormerlo LE et al (2012) Eur J Heart Failure Supplements 11:S15–S64https://doi.org/10.1093/eurjhf/hss006

21.

Bilchick KC, Auger DA, Abdishektaei M, Mathew R, Sohn MW, Cai X, Sun C, Narayan A, Malhotra R, Darby A, Mangrum JM, Mehta N, Ferguson J, Mazimba S, Mason PK, Kramer CM, Levy WC, Epstein FH (2020) CMR DENSE and the Seattle heart failure model inform survival and arrhythmia risk after CRT. JACC Cardiovasc Imaging 13(4):924–936. https://doi.org/10.1016/j.jcmg.2019.10.017CrossRefPubMed

22.

Elming MB, Hammer-Hansen S, Voges I, Nyktari E, Raja AA, Svendsen JH, Pehrson S, Signorovitch J, Køber L, Prasad SK, Thune JJ (2020) Myocardial fibrosis and the effect of primary prophylactic defibrillator implantation in patients with non-ischemic systolic heart failure-DANISH-MRI. Am Heart J 221:165–176. https://doi.org/10.1016/j.ahj.2019.10.020CrossRefPubMed

23.

Berdibekov B, Aleksandrova S, Bulaeva N, Gromova O, Golukhova E (2021) Looking for appropriate criterias for SCD prevention: prognostic role of MRI in patients with nonischemic ventricular arrhythmias. Eur Heart J 42(SUPPL 1):219

24.

Sánchez-Somonte P, Quinto L, Garre P, Zaraket F, Alarcón F, Borràs R, Caixal G, Vázquez S, Prat S, Ortiz-Perez JT, Perea RJ, Guasch E, Tolosana JM, Berruezo A, Arbelo E, Sitges M, Mont L, Roca-Luque I (2021) Scar channels in cardiac magnetic resonance to predict appropriate therapies in primary prevention. Heart Rhythm 18(8):1336–1343. https://doi.org/10.1016/j.hrthm.2021.04.017CrossRefPubMed

25.

Leyva F, Zegard A, Okafor O, Foley P, Umar F, Taylor RJ, Marshall H, Stegemann B, Moody W, Steeds RP, Halliday BP, Hammersley DJ, Jones RE, Prasad SK, Qiu T (2022) Myocardial fibrosis predicts ventricular arrhythmias and sudden death after cardiac electronic device implantation. J Am Coll Cardiol 79(7):665–678. https://doi.org/10.1016/j.jacc.2021.11.050CrossRefPubMed

26.

Alexandre J, Saloux E, Dugué AE, Lebon A, Lemaitre A, Roule V, Labombarda F, Provost N, Gomes S, Scanu P, Milliez P (2013) Scar extent evaluated by late gadolinium enhancement CMR: a powerful predictor of long term appropriate ICD therapy in patients with coronary artery disease. J Cardiovasc Magn Reson 15(1):12. https://doi.org/10.1186/1532-429X-15-12CrossRefPubMedPubMedCentral

27.

Sofia Alegria S, Simoes O, Miranda R, Sofia Alegria S, Simoes O, Miranda R, Almeida S, Almeida AR, Lopes L et al (2016) Abstracts of the heart failure 2016 conference, Florence, Italy, 21-24 May 2016. Eur J Heart Fail 18(Suppl 1):8–521. https://doi.org/10.1002/ejhf.539CrossRef

28.

Chaudhry U, Platonov PG, Jablonowski R, Couderc JP, Engblom H, Xia X, Wieslander B, Atwater BD, Strauss DG, Van der Pals J, Ugander M, Carlsson M, Borgquist R (2017) Evaluation of the ECG based Selvester scoring method to estimate myocardial scar burden and predict clinical outcome in patients with left bundle branch block, with comparison to late gadolinium enhancement CMR imaging. Ann Noninvasive Electrocardiol 22(5):e12440. https://doi.org/10.1111/anec.12440CrossRefPubMedPubMedCentral

29.

Travieso Gonzalez A, Islas F, FerrandezEscarabajal M, Luque-Diaz TS, Palacios-Rubio J, Luaces M et al (2019) Role of cardiac imaging in the prediction of ventricular arrythmias, heart failure and death in dilated non-ischemic cardiomyopathy with severe left ventricular systolic disfunction. Eur Heart J 40(Supplement_1):ehz746.1049. https://doi.org/10.1093/eurheartj/ehz746.1049CrossRef

30.

Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK (2002) Changing incidence of out-of-hospital ventricular fibrillation, 1980–2000. JAMA 288(23):3008–13. https://doi.org/10.1001/jama.288.23.3008CrossRefPubMed

31.

Goldenberg I, Moss AJ, Hall WJ, Foster E, Goldberger JJ, Santucci P, Shinn T, Solomon S, Steinberg JS, Wilber D, Barsheshet A, McNitt S, Zareba W, Klein H (2011) MADIT-CRT Executive Committee. Predictors of response to cardiac resynchronization therapy in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT). Circulation 124(14):1527–36. https://doi.org/10.1161/CIRCULATIONAHA.110.014324CrossRefPubMed

32.

Behon A, Schwertner WR, Merkel ED, Kovács A, Lakatos BK, Zima E, Gellér L, Kutyifa V, Kosztin A, Merkely B (2020) Lateral left ventricular lead position is superior to posterior position in long-term outcome of patients who underwent cardiac resynchronization therapy. ESC Heart Fail 7(6):3374–3382. https://doi.org/10.1002/ehf2.13066CrossRefPubMedPubMedCentral

33.

Gold MR, Thébault C, Linde C, Abraham WT, Gerritse B, Ghio S, St John Sutton M, Daubert JC (2012) Effect of QRS duration and morphology on cardiac resynchronization therapy outcomes in mild heart failure: results from the Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE) study. Circulation 126(7):822–9. https://doi.org/10.1161/CIRCULATIONAHA.112.097709CrossRefPubMed

34.

Bleeker GB, Kaandorp TA, Lamb HJ, Boersma E, Steendijk P, de Roos A, van der Wall EE, Schalij MJ, Bax JJ (2006) Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation 113(7):969–76. https://doi.org/10.1161/CIRCULATIONAHA.105.543678CrossRefPubMed

35.

Merkely B, Gellér L, Zima E, Osztheimer I, Molnár L, Földesi C, Duray G, Wranicz JK, Németh M, Goscinska-Bis K, Hatala R, Sághy L, Veres B, Schwertner WR, Fábián A, Fodor E, Goldenberg I, Kutyifa V, Kovács A, Kosztin (2022) A. Baseline clinical characteristics of heart failure patients with reduced ejection fraction enrolled in the BUDAPEST-CRT Upgrade trial. Eur J Heart Fail 24(9):1652-1661. https://doi.org/10.1002/ejhf.2609

36.

Merkely B, Hatala R, Wranicz JK, Duray G, Földesi C, Som Z, Németh M, Goscinska-Bis K, Gellér L, Zima E, Osztheimer I, Molnár L, Karády J, Hindricks G, Goldenberg I, Klein H, Szigeti M, Solomon SD, Kutyifa V, Kovács A, Kosztin A (2023) Upgrade of right ventricular pacing to cardiac resynchronization therapy in heart failure: a randomized trial. Eur Heart J. 44(40):4259–4269. https://doi.org/10.1093/eurheartj/ehad591CrossRefPubMedPubMedCentral

37.

Rohde LE, Chatterjee NA, Vaduganathan M, Claggett B, Packer M, Desai AS, Zile M, Rouleau J, Swedberg K, Lefkowitz M, Shi V, McMurray JJV, Solomon SD (2020) Sacubitril/valsartan and sudden cardiac death according to implantable cardioverter-defibrillator use and heart failure cause: a PARADIGM-HF analysis. JACC Heart Fail 8(10):844–855. https://doi.org/10.1016/j.jchf.2020.06.015CrossRefPubMed

38.

Koev I, Yarkoni M, Luria D, Amir O, Biton Y (2023) Sudden cardiac death prevention in the era of novel heart failure medications. Am Heart J Plus: Cardiol Res Pract 27:100281. ISSN 2666-6022. https://doi.org/10.1016/j.ahjo.2023.100281

39.

Kutyifa V, Geller L, Bogyi P, Zima E, Aktas MK, Ozcan EE, Becker D, Nagy VK, Kosztin A, Szilagyi S, Merkely B (2014) Effect of cardiac resynchronization therapy with implantable cardioverter defibrillator versus cardiac resynchronization therapy with pacemaker on mortality in heart failure patients: results of a high-volume, single-centre experience. Eur J Heart Fail 16(12):1323–30. https://doi.org/10.1002/ejhf.185CrossRefPubMed

40.

Veres B, Schwertner WR, Tokodi M, Szijártó Á, Kovács A, Merkel ED, Behon A, Kuthi L, Masszi R, Gellér L, Zima E, Molnár L, Osztheimer I, Becker D, Kosztin A, Merkely B (2023) Topological data analysis to identify cardiac resynchronization therapy patients exhibiting benefit from an implantable cardioverter-defibrillator. Clin Res Cardiol. https://doi.org/10.1007/s00392-023-02281-6CrossRefPubMed

41.

Veres B, Fehérvári P, Engh MA, Hegyi P, Gharehdaghi S, Zima E, Duray G, Merkely B, Kosztin A (2023) Time-trend treatment effect of cardiac resynchronization therapy with or without defibrillator on mortality: a systematic review and meta-analysis. Europace 25(10):euad289. https://doi.org/10.1093/europace/euad289CrossRefPubMedPubMedCentral

42.

Køber L, Thune JJ, Nielsen JC, Haarbo J, Videbæk L, Korup E, Jensen G, Hildebrandt P, Steffensen FH, Bruun NE, Eiskjær H, Brandes A, Thøgersen AM, Gustafsson F, Egstrup K, Videbæk R, Hassager C, Svendsen JH, Høfsten DE, Torp-Pedersen C, Pehrson S, DANISH Investigators (2016) defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med 375(13):1221–30. https://doi.org/10.1056/NEJMoa1608029CrossRefPubMed

43.

Greulich S, Seitz A, Herter D, Günther F, Probst S, Bekeredjian R, Gawaz M, Sechtem U, Mahrholdt H (2021) Long-term risk of sudden cardiac death in hypertrophic cardiomyopathy: a cardiac magnetic resonance outcome study. Eur Heart J Cardiovasc Imaging 22(7):732–741. https://doi.org/10.1093/ehjci/jeaa423CrossRefPubMedPubMedCentral

44.

Thomsen AF, Bertelsen L, Jøns C, Jabbari R, Lønborg J, Kyhl K, Göransson C, Nepper-Christensen L, Atharovski K, Ekström K, Tilsted HH, Pedersen F, Køber L, Engstrøm T, Vejlstrup N, Jacobsen PK (2023) Scar border zone mass and presence of border zone channels assessed with cardiac magnetic resonance imaging are associated with ventricular arrhythmia in patients with ST-segment elevation myocardial infarction. Europace 25(3):978–988. https://doi.org/10.1093/europace/euac256CrossRefPubMed

45.

Kolentinis M, Carerj LM, Vidalakis E, Giokoglu E, Martin S, Arendt C, Vogl TJ, Nagel E, Puntmann VO (2022) Determination of scar area using native and post-contrast T1 mapping: agreement with late gadolinium enhancement. Eur J Radiol 150:110242. https://doi.org/10.1016/j.ejrad.2022.110242CrossRefPubMed

46.

Dagres N, Peek N, Leclercq C, Hindricks G (2020) The PROFID project. Eur Heart J 41(39):3781–3782. https://doi.org/10.1093/eurheartj/ehaa645CrossRefPubMedPubMedCentral

47.

Hadwiger M, Dagres N, Haug J, Wolf M, Marschall U, Tijssen J, Katalinic A, Frielitz FS, Hindricks G (2022) Survival of patients undergoing cardiac resynchronization therapy with or without defibrillator: the RESET-CRT project. Eur Heart J 43(27):2591–2599. https://doi.org/10.1093/eurheartj/ehac053CrossRefPubMedPubMedCentral

48.

Flett A, Cebula A, Nicholas Z, Adam R, Ewings S, Prasad S, Cleland JG, Eminton Z, Curzen N (2023) Rationale and study protocol for the BRITISH randomized trial (Using cardiovascular magnetic resonance identified scar as the benchmark risk indication tool for implantable cardioverter defibrillators in patients with nonischemic cardiomyopathy and severe systolic heart failure). Am Heart J 266:149–158. https://doi.org/10.1016/j.ahj.2023.09.008CrossRefPubMed

49.

Taborsky M, Skala T, Aiglova R, Fedorco M, Kautzner J, Jandik T, Vancura V, Linhart A, Valek M, Novak M, Kala P, Polasek R, Roubicek T, Schee A, Hindricks G, Dagres N, Hatala R, Jarkovsky J (2022) Cardiac Resynchronization and Defibrillator Therapy (CRT-D) or CRT Alone (CRT-P) in patients with dilated cardiomyopathy and heart failure without late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (CMRI) high-risk markers - CRT-REALITY study - study design and rationale. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 166(2):173–179. https://doi.org/10.5507/bp.2021.015CrossRefPubMed

50.

Di Marco A, Anguera I, Schmitt M et al (2017) Late gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis. JACC Heart Fail 5(1):28–38. https://doi.org/10.1016/j.jchf.2016.09.017CrossRefPubMed

Title: Evaluating the predictive value of late gadolinium enhancement assessed by cardiac magnetic resonance on sudden cardiac death in patients selected for implantable cardioverter defibrillator and cardiac resynchronization therapy implantation: a systematic review and meta-analysis
Authors: Richárd Masszi
Előd-János Zsigmond
Réka Ehrenberger
Caner Turan
Péter Fehérvári
Brigitta Teutsch
Zsolt Molnár
Zsófia Drobni
Hajnalka Vágó
Péter Hegyi
Béla Merkely
Annamária Kosztin
Publication date: 08-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Sudden Cardiac Death
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Cardiac Resynchronization Therapy
Implantable Cardioverter Defibrillator
Implantable Cardioverter Defibrillator
Published in: Clinical Research in Cardiology
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-024-02441-2

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Evaluating the predictive value of late gadolinium enhancement assessed by cardiac magnetic resonance on sudden cardiac death in patients selected for implantable cardioverter defibrillator and cardiac resynchronization therapy implantation: a systematic review and meta-analysis

Abstract

Aims

Methods and results

Conclusion

Graphical abstract

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Abstract

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Conclusion

Graphical abstract

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ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

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