Left ventricular scarring may be a better determinant for implantable cardioverter defibrillator (ICD) candidacy than a low ejection fraction.
ICD Outcomes Tied to Cardiac Muscle Scarring
A significant amount of MRI-detected scarring in the myocardium is predictive of a poor prognosis in patients with an implantable cardioverter defibrillator (ICD) no matter the left ventricular ejection fraction (LVEF), according to a study in the July 31 issue of the Journal of the American College of Cardiology.
Of the 137 patients in the study, those with a LVEF greater than 30% had a six-fold increased risk of adverse events following ICD placement when they had more than 5% scarring compared with those with minimal or no scarring, reported Igor Klem, MD, from Duke University Medical Center in Durham, N.C., and colleagues.
Additionally, those with a LVEF >30% and significant scarring had a similar risk of sudden death or inappropriate ICD discharge as those with a LVEF <30% and no or minimal scarring.
Although LVEF is considered the gold standard for ICD placement, it lacks sensitivity and specificity, the researchers said. Cardiac MRI to detect LV scarring could help better risk stratify these patients, they concluded.
SOURCE: MedPage Today