title: Sudden cardiac death risk stratification.
abstract: Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.
authors.affiliation: From Heart Rhythm Services, the Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada (M.W.D., A.D.K.); and Center for Cardiovascular Innovation and the Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL (J.J.G.).
authors.forename: Marc W
authors.initials: MW
authors.lastname: Deyell
authors.affiliation: From Heart Rhythm Services, the Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada (M.W.D., A.D.K.); and Center for Cardiovascular Innovation and the Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL (J.J.G.).
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Krahn
authors.affiliation: From Heart Rhythm Services, the Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, Canada (M.W.D., A.D.K.); and Center for Cardiovascular Innovation and the Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL (J.J.G.). j-goldberger@northwestern.edu.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Goldberger
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D015415:Biomarkers; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D003935:Diagnostic Techniques, Cardiovascular; D004198:Disease Susceptibility; D005544:Forecasting; D006339:Heart Rate; D006801:Humans; D018570:Risk Assessment
chemical_list: D015415:Biomarkers
keywords: death, sudden, cardiac; risk assessment; tachycardia, ventricular