ArticleJACC. Clinical electrophysiology2018
Myocardial Scar But Not Ischemia Is Associated With Defibrillator Shocks and Sudden Cardiac Death in Stable Patients With Reduced Left Ventricular Ejection Fraction.
Article in JACC. Clinical electrophysiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 40 citations in OpenAlex.
- Predicting sudden cardiac death in heart failure with reduced ejection fraction.Heart failure reviews · 2026Review
- A Narrative Review of Risk Assessment Approaches for Implantable Defibrillator Therapy to Prevent Sudden Cardiac Death in Acute Myocardial Infarction.Cardiology research and practice · 2026Review
- Prediction of major arrhythmic outcomes in ischaemic cardiomyopathy: value of hibernating myocardium in positron emission tomography/computed tomography.European heart journal. Cardiovascular Imaging · 2024Article
- Predicting postinfarct ventricular tachycardia by integrating cardiac MRI and advanced computational reentrant pathway analysis.Heart rhythm · 2024Article
- Number of Premature Ventricular Complexes Predicts Long-Term Outcomes in Patients with Persistent Atrial Fibrillation.Biomedicines · 2024Article
- Assessment of resting myocardial blood flow in regions of known transmural scar to confirm accuracy and precision of 3D cardiac positron emission tomography.EJNMMI research · 2023Article
- Revascularization and Left Ventricular Dysfunction for ICD Eligibility.Life (Basel, Switzerland) · 2023Review
- Ventricular arrhythmias following coronary artery bypass grafting for ischemic cardiomyopathy: When to insert an implanted cardioverter defibrillator?JTCVS open · 2023Article
- Myocardial Viability Testing in the Management of Ischemic Heart Failure.Life (Basel, Switzerland) · 2022Review
- Myocardial viability testing: all STICHed up, or about to be REVIVED?European heart journal · 2022Article
- Advanced imaging for risk stratification for ventricular arrhythmias and sudden cardiac death.Frontiers in cardiovascular medicine · 2022Review
- Modalities for predicting events in patients with ICDs: Expanding the versatility of FDG PET.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Global and regional cardiac dysfunction quantified byJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Observational
- The Burden of Ventricular Premature Complex Is Associated With Cardiovascular Mortality.Frontiers in cardiovascular medicine · 2021Article
- Is PVC-Induced Cardiomyopathy Truly Reversible?: A Deep Dive Into Questions That Remain Unanswered.JACC. Clinical electrophysiology · 2020Article
- Clinical significance of chronic myocardial ischemia in coronary artery disease patients.Journal of thoracic disease · 2019Review
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThis study sought to investigate the association of myocardial scar and ischemia with major arrhythmic events (MAEs) in patients with left ventricular ejection fraction (LVEF) ≤35%.
backgroundAlthough myocardial scar is a known substrate for ventricular arrhythmias, the association of myocardial ischemia with ventricular arrhythmias in stable patients with left ventricular dysfunction is less clear.
methodsA total of 439 consecutive patients (median age, 70 years; 78% male; 55% with implantable cardioverter defibrillator [ICD]) referred for stress/rest positron emission tomography (PET) and resting LVEF ≤35% were included. Primary outcome was time-to-first MAE defined as sudden cardiac death, resuscitated sudden cardiac death, or appropriate ICD shocks for ventricular tachyarrhythmias ascertained by blinded adjudication of hospital records, Social Security Administration's Death Masterfile, National Death Index, and ICD vendor databases.
resultsNinety-one MAEs including 20 sudden cardiac deaths occurred in 75 (17%) patients during a median follow-up of 3.2 years. Transmural myocardial scar was strongly associated with MAEs beyond age, sex, cardiovascular risk factors, beta-blocker therapy, and resting LVEF (adjusted hazard ratio per 10% increase in scar, 1.48 [95% confidence interval: 1.22 to 1.80]; p < 0.001). However, non transmural scar/hibernation or markers of myocardial ischemia on PET including global or peri-infarct ischemia, coronary flow reserve, and resting or hyperemic myocardial blood flows were not associated with MAEs in univariable or multivariable analysis. These findings remained robust in subgroup analyses of patients with ICD (n = 223), with ischemic cardiomyopathy (n = 287), and in patients without revascularization after the PET scan (n = 365).
conclusionsMyocardial scar but not ischemia was associated with appropriate ICD shocks and sudden cardiac death in patients with LVEF ≤35%. These findings have implications for risk-stratification of patients with left ventricular dysfunction who may benefit from ICD therapy.
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