Management of sudden cardiac death risk in the very early postmyocardial infarction period

Emile G Daoud; John D Hummel; Troy E Rhodes

doi:10.1097/HCO.0b013e3283387a51

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Management of sudden cardiac death risk in the very early postmyocardial infarction period

Journal article

Peer reviewed

Management of sudden cardiac death risk in the very early postmyocardial infarction period

Emile G Daoud, John D Hummel and Troy E Rhodes

Current opinion in cardiology, Vol.25(3), pp.253-261

05/2010

DOI: 10.1097/HCO.0b013e3283387a51

PMID: 22393566

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Abstract

The purpose of this review is to summarize the numerous recent studies assessing the strategies to manage the increased risk of sudden cardiac death (SCD) early after a myocardial infarction (MI). Early after a MI, the risk of SCD is high. Several trials have been completed in attempt to identify and treat patients at increased risk for SCD early post-MI. These trials have evaluated QT interval, cardiac autonomic modulation, signal-averaged ECG, microvolt T-wave alternans, electrophysiology testing and early measurement of the left-ventricular ejection fraction (LVEF). Although some of these parameters were associated with increased total mortality, no parameter provided adequate predictive accuracy of increased risk for SCD that could guide use of an implantable cardiac defibrillator (ICD). Other than LVEF measured more than 40 days post-MI (consistent with current ICD guidelines), there is no noninvasive or invasive test that reliably predicts the risk for SCD or that can guide empiric ICD implantation soon after a MI. In the early post-MI period, therefore, the goal is to maximize medical therapy and revascularization. The LVEF should then be measured no sooner than 40 days post-MI and, if the LVEF is 35% or less, the patient should be considered for ICD implantation.

Myocardial Infarction - diagnosis

Risk Assessment - methods

Myocardial Infarction - mortality

Humans

Risk Factors

Death, Sudden, Cardiac - prevention & control

Death, Sudden, Cardiac - etiology

Stroke Volume

Myocardial Infarction - complications

Myocardial Infarction - therapy

Defibrillators, Implantable

Electrocardiography

Disease Management

Details

Title: Subtitle: Management of sudden cardiac death risk in the very early postmyocardial infarction period
Creators: Emile G Daoud - Department of Medicine, Division of Cardiology, Richard M. Ross Heart Hospital, The Ohio State University Medical Center, Columbus, Ohio, USA. emile.daoud@osumc.edu
John D Hummel
Troy E Rhodes
Resource Type: Journal article
Publication Details: Current opinion in cardiology, Vol.25(3), pp.253-261
DOI: 10.1097/HCO.0b013e3283387a51
PMID: 22393566
ISSN: 0268-4705
eISSN: 1531-7080
Language: English
Date published: 05/2010
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094752202771

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