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Open Access 06-03-2023 | Sudden Cardiac Death

Noninvasive electrocardiographic risk factors for sudden cardiac death in dilated ca rdiomyopathy: is ambulatory electrocardiography still relevant?

Authors: Nikias Milaras, Panagiotis Dourvas, Ioannis Doundoulakis, Zoi Sotiriou, Vasileios Nevras, Anastasia Xintarakou, Aggeliki Laina, Stergios Soulaidopoulos, Panagiotis Zachos, Athanasios Kordalis, Petros Arsenos, Stefanos Archontakis, Christos-Konstantinos Antoniou, Dimitrios Tsiachris, Polychronis Dilaveris, Konstantinos Tsioufis, Skevos Sideris, Konstantinos Gatzoulis

Published in: Heart Failure Reviews | Issue 4/2023

Abstract

Risk stratification for sudden cardiac death in dilated cardiomyopathy is a field of constant debate, and the currently proposed criteria have been widely questioned due to their low positive and negative predictive value. In this study, we conducted a systematic review of the literature utilizing the PubMed and Cochrane library platforms, in order to gain insight about dilated cardiomyopathy and its arrhythmic risk stratification utilizing noninvasive risk markers derived mainly from 24 h electrocardiographic monitoring. The obtained articles were reviewed in order to register the various electrocardiographic noninvasive risk factors used, their prevalence, and their prognostic significance in dilated cardiomyopathy. Premature ventricular complexes, nonsustained ventricular tachycardia, late potentials on Signal averaged electrocardiography, T wave alternans, heart rate variability and deceleration capacity of the heart rate, all have both some positive and negative predictive value to identify patients in higher likelihood for ventricular arrhythmias and sudden cardiac death. Corrected QT, QT dispersion, and turbulence slope–turbulence onset of heart rate have yet to establish a predictive correlation in the literature. Although ambulatory electrocardiographic monitoring is frequently used in clinical practice in DCM patients, no single risk marker can be used for the selection of patients at high-risk for malignant ventricular arrhythmic events and sudden cardiac death who could benefit from the implantation of a defibrillator. More studies are needed in order to establish a risk score or a combination of risk factors with the purpose of selecting high-risk patients for ICD implantation in the context of primary prevention.

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Title: Noninvasive electrocardiographic risk factors for sudden cardiac death in dilated ca rdiomyopathy: is ambulatory electrocardiography still relevant?
Authors: Nikias Milaras
Panagiotis Dourvas
Ioannis Doundoulakis
Zoi Sotiriou
Vasileios Nevras
Anastasia Xintarakou
Aggeliki Laina
Stergios Soulaidopoulos
Panagiotis Zachos
Athanasios Kordalis
Petros Arsenos
Stefanos Archontakis
Christos-Konstantinos Antoniou
Dimitrios Tsiachris
Polychronis Dilaveris
Konstantinos Tsioufis
Skevos Sideris
Konstantinos Gatzoulis
Publication date: 06-03-2023
Publisher: Springer US
Keywords: Sudden Cardiac Death
Cardiomyopathy
Electrocardiography
Ventricular Tachycardia
Ventricular Fibrillation
Electrocardiography
Published in: Heart Failure Reviews / Issue 4/2023
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-023-10300-x

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