title: [Remarks on polyparametric assessment of sudden death risk for primary prevention ICD implantation in patients with left ventricular dysfunction of ischemic and non ischemic etiology. Italian Association of Hospital Cardiologists (ANMCO) Experts Position Paper].
abstract: It is generally recognized that current guidelines, based on ejection fraction criteria, do not allow appropriate selection of patients for implantable cardioverter-defibrillator (ICD) therapy in the primary prevention of sudden death, thus hindering the optimal use of ICD in patients with left ventricular dysfunction of ischemic and nonischemic etiology. Ejection fraction alone has limitations in both sensitivity and specificity. Assessment of the risk for sudden death using a combination of multiple tests (ejection fraction associated with one or more different arrhythmic risk markers) could partially compensate for these limitations. In this position paper, the potential usefulness of a polyparametric assessment using some of the most investigated risk markers of sudden death is discussed, including late gadolinium enhancement cardiac magnetic resonance, programmed ventricular stimulation, T-wave alternans, autonomic tone, biomarkers, and genetic testing.
authors.affiliation: Dipartimento di Cardiologia, APSS - Progetto Innovazione e Ricerca Clinica in Sanità, PAT-FBK, Trento.
authors.forename: Marcello
authors.initials: M
authors.lastname: Disertori
authors.affiliation: U.O. Cardiologia, Ospedale Garibaldi-Nesima, Catania.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Gulizia
authors.affiliation: U.O. Cardiologia, Ospedale Versilia, Lido di Camaiore (LU).
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Casolo
authors.affiliation: Cardiologia, Casa di Cura Polispecialistica Pederzoli, Peschiera del Garda (VR).
authors.forename: Pietro
authors.initials: P
authors.lastname: Delise
authors.affiliation: Centro Cardiovascolare, Azienda per l'Assistenza Sanitaria n. 1, Università degli Studi, Trieste.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
authors.affiliation: U.O. Cardiologia, A.O. Istituti Ospitalieri, Cremona.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Tano
authors.affiliation: Dipartimento Cardiotoracovascolare "A. De Gasperis", A.O. Ospedale Niguarda Ca' Granda, Milano.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lunati
authors.affiliation: Cardiovascular Institute, University of Colorado Denver AMC, Aurora, Colorado, USA.
authors.forename: Luisa
authors.initials: L
authors.lastname: Mestroni
authors.affiliation: Clinica Cardiologica, Ospedale di Circolo e Fondazione Macchi, Università degli Studi dell'Insubria, Varese.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Salerno-Uriarte
authors.affiliation: GVM Care & Research, Ospedale Maria Cecilia, Cotignola (RA), ES Health Science Foundation.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D006801:Humans; D007558:Italy; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000628:therapy*