Assessment of ICD eligibility in non-ischaemic cardiomyopathy patients: a position statement by the Task Force of the Dutch Society of Cardiology

Anne Lotte C.J. van der Lingen, Tom E. Verstraelen, Lieselot van Erven, Joan G. Meeder, Dominic A. Theuns, Kevin Vernooy, Arthur A.M. Wilde, Alexander H. Maass, Cornelis P. Allaart*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

International guidelines recommend implantation of an implantable cardioverter-defibrillator (ICD) in non-ischaemic cardiomyopathy (NICM) patients with a left ventricular ejection fraction (LVEF) below 35% despite optimal medical therapy and a life expectancy of more than 1 year with good functional status. We propose refinement of these recommendations in patients with NICM, with careful consideration of additional risk parameters for both arrhythmic and non-arrhythmic death. These additional parameters include late gadolinium enhancement on cardiac magnetic resonance imaging and genetic testing for high-risk genetic variants to further assess arrhythmic risk, and age, comorbidities and sex for assessment of non-arrhythmic mortality risk. Moreover, several risk modifiers should be taken into account, such as concomitant arrhythmias that may affect LVEF (atrial fibrillation, premature ventricular beats) and resynchronisation therapy. Even though currently no valid cut-off values have been established, the proposed approach provides a more careful consideration of risks that may result in withholding ICD implantation in patients with low arrhythmic risk and substantial non-arrhythmic mortality risk.

Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalNetherlands Heart Journal
Volume32
Issue number5
Early online date18 Apr 2024
DOIs
Publication statusPublished - May 2024

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Publisher Copyright:
© The Author(s) 2024.

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