Preventing Sudden Death in Idiopathic Dilated Cardiomyopathy: A Difficult to Settle Issue

Risk stratification for sudden cardiac death in non-ischemic dilated cardiomyopathy remains a difficult and controversial issue. This is currently guided by left ventricular ejection fraction, severity of heart failure symptoms according to New York Heart Association classification, and the morphology and duration of the QRS complex. The results of a recent study stirred some initial controversy with regards to the utility of the implantable cardioverter defibrillator in these patients, however, a subsequent meta-analysis confirmed prior findings of the survival-prolonging benefit of device therapy. These issues are herein briefly reviewed. Rhythmos 2017;12(1):1-6.