Application of Noninvasive and Invasive Tests for Risk Assessment in Patients With Ventricular Arrhythmias

Risk Assessment for Sudden Cardiac Death in Dialysis Patients

“…The slope of such a curve is determined by the relative input of sympathetic and parasympathetic control on the heart, with a flat slope indicating sympathetic dominance and higher risk of SCD. 38 A more recent addition is the baroreflex effectiveness index, which estimates the number of times the baroreflex is active in controlling the heart rate in response to blood pressure fluctuations. 39 One recent study reported that reduced baroreflex effectiveness index and baroreceptor sensitivity are independent predictors of allcause mortality and SCD, respectively, in a cohort of patients with hypertension and chronic kidney disease.…”

“…LPs in SAECG have been reported to predict SCD in patients with various ischemic and nonischemic cardiac conditions. 38 The common denominator in all these conditions is the presence of abnormal areas of ventricular myocardium where activation is delayed by slow conduction, thus predisposing to reentrant tachycardia.…”

Heart Failure Devices

“…However, for many of these risk-stratification tests, high positive and negative predictive values have not been consistently obtained. A multifactorial model 40 may be scientifically most appropriate to determine the risk of cardiac arrest, but it is unclear whether such a model can be widely applied clinically. Thus, selection of patients for trials examining the efficacy of the ICD in the primary prevention of sudden death has typically been based on ejection fraction and, at most, 1 or 2 other risk-stratification tests.…”

Temporal Variations in Microvolt T‐Wave Alternans Testing after Acute Myocardial Infarction

“…Acute myocardial infarction (AMI) survivors represent an important risk population for the occurrence of SCD due to ventricular tachyarrhythmias 2,3 . Several risk stratification methods, based on different noninvasive diagnostic techniques, accepted as risk markers of serious ventricular arrhythmias, have been proposed in clinical practice but they either lack adequate sensitivity or tend to show limited positive predictive value 3–5 . Microvolt T‐wave alternans (TWA) has recently been recognized as a tool for the assessment of vulnerability to ventricular arrhythmias.…”