title: Electrophysiologic testing guided risk stratification approach for sudden cardiac death beyond the left ventricular ejection fraction.
abstract: Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators (ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death.
authors.affiliation: Konstantinos A Gatzoulis, Dimitris Tsiachris, Petros Arsenos, Dimitris Tousoulis, First Cardiology Division, Hippokration Hospital, University of Athens, 11527 Athens, Greece.
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Gatzoulis
authors.affiliation: Konstantinos A Gatzoulis, Dimitris Tsiachris, Petros Arsenos, Dimitris Tousoulis, First Cardiology Division, Hippokration Hospital, University of Athens, 11527 Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsiachris
authors.affiliation: Konstantinos A Gatzoulis, Dimitris Tsiachris, Petros Arsenos, Dimitris Tousoulis, First Cardiology Division, Hippokration Hospital, University of Athens, 11527 Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Arsenos
authors.affiliation: Konstantinos A Gatzoulis, Dimitris Tsiachris, Petros Arsenos, Dimitris Tousoulis, First Cardiology Division, Hippokration Hospital, University of Athens, 11527 Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
keywords: Electrophysiologic study; Myocardial infarction; Preserved ejection fraction; Risk stratification; Sudden cardiac death
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