Clinical Electrophysiology -> SCA Risk Assessment: -> Clinical Risk Assessment Techniques D-AB11 - Emerging Innovations to Predict Sudden Death (ID 18) Abstract Plus

D-AB11-05 - Predicting The Risk Of Life Threatening Ventricular Tachyarrhythmias In Patients With Non-ischemic Cardiomyopathy And An Implantable Defibrillator (ID 743)

 I. Goldenberg: Nothing relevant to disclose.


Background: The implantable cardioverter defibrillator (ICD) is effective in reducing mortality among patients with heart failure (HF) due to ischemic heart disease. However, a recent trial has called into question ICD benefit in patients with HF that is due to non-ischemic cardiomyopathy (NICM).
Objective: The purpose of this study was to construct a score that would predict the risk for ventricular tachyarrhythmia (VTA) in patients with NICM.
Methods: The study population comprised 668 patients with NICM who were enrolled in MADIT-RIT. We used Fine and Gray analysis to develop a model that would predict an occurrence of VTA while accounting for the competing risk of death without experiencing a VTA. Patients were then grouped into 3 strata based on their risk score.
Results: Four factors associated with increased risk for VTA were identified: ICD implantation as opposed to CRT-D, male gender, body mass index (BMI)>28 kg/m2, and systolic blood pressure (SBP)<120 mmHg (HR:1.66, 1.94,1.86, and 2.08, respectively; all p<0.015). Based on this model, patients were subsequently stratified into three distinct risk groups (Figure). The two-year cumulative incidences of VTA in the lowest, middle, and highest risk groups were 8%, 20%, and 45% respectively (p<0.001).
Conclusion: Translating these characteristics into a scoring system may allow for individualized risk stratification for VTA among patients with NICM.