The Challenge of Assessing Sudden Cardiac Death Risk in Patients with Nonischemic Heart Failure

Sudden cardiac death (SCD) accounts for approximately 50% of deaths in patients with ischemic and nonischemic heart disease in the presence of severe left ventricular systolic dysfunction. Many clinical trials^– have evaluated the effectiveness of implantable cardioverter defibrillators (ICDs) in primary prevention of SCD in the last 20 years.

The Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) and the Sudden Cardiac Death in Heart Failure (SCD-HeFT) defined the principles for indication^, of ICDs in primary prophylaxis of SCD of patients with heart failure (HF) of ischemic etiology. On the other hand, clinical trials evaluating patients with HF of nonischemic origin^,– have shown heterogeneous results and, so far, there are uncertainties on the best candidates for this type of therapy.

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