Arrhythmic death and ICD implantation after myocardial infarction
Abstract
Overview
Arrhythmic death remains one of the most important causes of mortality after an
acute myocardial infarction also in the revascularization era. As a consequence, identification of
patients at risk should be performed before discharge. Unfortunately, in the clinical practice, this
evaluation is mainly based on detection of a depressed left ventricular ejection. This approach,
however, cannot adequately distinguish arrhythmic versus non-arrhythmic risk.
This issue is of critical relevance when considering that arrhythmic death can be significantly reduced
by appropriate interventions of implantable cardioverter defibrillator. Available evidence,
however, indicates that in the first month after myocardial infarction, device implantation does
not significantly reduce cardiac mortality: it seems that the reduction of arrhythmic death is
counterbalanced by an increase in rate of death from non arrhythmic cause. It is therefore to be
hoped that, in the future, arrhythmic risk evaluation will be based not only on the extent of left
ventricular dysfunction but also on the analysis of other risk markers such as those reflecting autonomic
dysfunction, cardiac electrical instability and presence of subclinical inflammation.
(Heart International 2006; 2: 12-6)
Keywords
Sudden cardiac death, Acute myocardial infarction, Implantable cardioverter defibrillator, T wave alternans
Article Information
Correspondence
Federico Lombardi, MD, FESC, Cardiologia, Dip. di Medicina, Chirurgia e Odontoiatria, Osp. San Paolo, University of Milan, Via A. di Rudinì, 8, 20142 Milano – Italy, Federico.Lombardi@unimi.it
Further Resources
Trending Topic
Cardiovascular care continues to evolve in response to increasingly complex clinical realities, where advances in intervention, electrophysiology and population health must be integrated with a more critical appraisal of long-held assumptions. Across disciplines, there is a growing recognition that improving outcomes depends not only on technological progress, but also on refining our understanding of mechanisms, […]
Cardiovascular care continues to evolve in response to increasingly complex clinical realities, where advances in intervention, electrophysiology and population health must be integrated with a more critical appraisal of long-held assumptions. Across disciplines, there is a growing recognition that improving ...
After decades of debate, patent foramen ovale (PFO) closure is now a well-established strategy to reduce recurrent stroke in patients aged 18–60 years who have had a PFO-associated stroke.1 Patients who underwent PFO closure continue to have a higher stroke risk ...
Cardiovascular medicine continues to advance at a remarkable pace, driven by innovation, interdisciplinary collaboration and an ever-deepening understanding of disease mechanisms. As patient populations age and chronic conditions become increasingly complex, the field stands at the intersection of precision therapy, ...
Cardiovascular medicine stands at a pivotal crossroads—shaped by rapid advances in precision therapies, a deepening understanding of disease mechanisms, and an urgent imperative to address global health disparities. As the burden of cardiovascular disease continues to evolve, so too ...
Conduction system pacing (CSP) is being increasingly adopted as a more physiological alternative to right ventricular and biventricular pacing and is an integral part of the European Heart Rhythm Association (EHRA) core curriculum for the device specialist.1–6 Left bundle branch ...
Welcome to this issue of Heart International. As ever, we aim to provide our readers with the latest developments, insights, and evidence-based discussions in cardiovascular care. This edition is particularly poignant, as we begin with a heartfelt tribute to an ...
Forty-seven years ago, Andreas Gruentzig introduced ‘percutaneous transluminal coronary angioplasty’ (PTCA) as a new approach to treating symptomatic occlusive coronary artery disease.1 The mechanism of balloon angioplasty (BA) formed the foundation around which newer equipment and technologies were developed, including ...
Tricuspid regurgitation (TR) is a frequent finding on echocardiography, with detection rates reaching up to 86% across the different ranges of severity, with moderate or greater TR being reported in at least 6–8% of patients.1–3 The prevalence of TR increases with age, ...
Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1Â Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2Â It is conventionally performed via the trans-femoral (TF) route. Recently, however, ...
We are sorry to announce the death of one of our valued editorial board members, Dr Richard Heuser (November 17, 1950–May 23, 2024). Richard R Heuser, MD, FACC, FACP, FESC, MSCAI, was an internationally recognized cardiologist, inventor, educator and author, and was a ...
Welcome to the summer issue of Heart International. We are excited to present a collection of insightful articles that delve into various aspects of cardiovascular health and related interventions. This issue encompasses a wide array of topics, from novel treatment ...
Clinically relevant tricuspid regurgitation (TR) is a common disorder, affecting approximately 4% of people 75 years of age or older.1Â If left untreated, severe TR results in volume overload and right ventricular remodelling. This eventually leads to symptomatic right-sided heart failure, along ...
Log into your Touch Account
Keep track of your clinical interests and newsletter subscriptions.
Sign up with an Email
Or use a .
Register now for FREE access
Already registered? Login below.
