Stratificazione del rischio aritmico nell'infartuato: Riflessioni alla luce dei grandi trial

Translated title of the contribution: Arrhythmic risk stratification after myocardial infarction: An overview

Research output: Contribution to journalArticle

Abstract

The identification of patients at higher risk of life-threatening ventricular arrhythmias after myocardial infarction still represents a clinically relevant problem, particularly after results of recent studies which support the efficacy of implantable cardioverter defibrillator (ICD) in reducing total mortality in patients with a previous myocardial infarction and left ventricular dysfunction, with and without additional risk markers. However, owing to the high cost of ICD therapy, an effective arrhythmic risk stratification may be desirable. The low diagnostic accuracy reported by various studies using single risk stratifiers (either invasive and non invasive) suggested a combined use of multiple parameters in order to improve the predictive power of the risk stratification algorithms. This approach, that takes into account the multifactorial genesis of malignant ventricular arrhythmias, has been demonstrated to be able to identify subgroups of patients at very high arrhythmic risk. In particular, a two-level algorithm based upon the selection of candidates to electrophysiologic study among patients with abnormal non-invasive testing, showed itself as a particularly effective tool for identification of such patients. In this paper the Authors summarize most recent results on the risk stratification protocols and the use of ICDs and provide an operative algorithm that keeps into account either aggressive and moderate approaches to patients surviving a myocardial infarction.

Original languageItalian
Pages (from-to)42-46
Number of pages5
JournalMonaldi Archives for Chest Disease - Cardiac Series
Volume58
Issue number1
Publication statusPublished - 2002

Fingerprint

Myocardial Infarction
Implantable Defibrillators
Cardiac Arrhythmias
Left Ventricular Dysfunction
Costs and Cost Analysis
Mortality
Therapeutics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{11762643d0e44632b699a505e04fb07a,
title = "Stratificazione del rischio aritmico nell'infartuato: Riflessioni alla luce dei grandi trial",
abstract = "The identification of patients at higher risk of life-threatening ventricular arrhythmias after myocardial infarction still represents a clinically relevant problem, particularly after results of recent studies which support the efficacy of implantable cardioverter defibrillator (ICD) in reducing total mortality in patients with a previous myocardial infarction and left ventricular dysfunction, with and without additional risk markers. However, owing to the high cost of ICD therapy, an effective arrhythmic risk stratification may be desirable. The low diagnostic accuracy reported by various studies using single risk stratifiers (either invasive and non invasive) suggested a combined use of multiple parameters in order to improve the predictive power of the risk stratification algorithms. This approach, that takes into account the multifactorial genesis of malignant ventricular arrhythmias, has been demonstrated to be able to identify subgroups of patients at very high arrhythmic risk. In particular, a two-level algorithm based upon the selection of candidates to electrophysiologic study among patients with abnormal non-invasive testing, showed itself as a particularly effective tool for identification of such patients. In this paper the Authors summarize most recent results on the risk stratification protocols and the use of ICDs and provide an operative algorithm that keeps into account either aggressive and moderate approaches to patients surviving a myocardial infarction.",
keywords = "Impiantable cardioverter defibrillator, Myocardial infarction, Ventricular arrhythmias",
author = "Pedretti, {R. F E} and Braga, {S. Sarzi}",
year = "2002",
language = "Italian",
volume = "58",
pages = "42--46",
journal = "Monaldi Archives for Chest Disease",
issn = "1122-0643",
publisher = "Fondazione Salvatore Maugeri",
number = "1",

}

TY - JOUR

T1 - Stratificazione del rischio aritmico nell'infartuato

T2 - Riflessioni alla luce dei grandi trial

AU - Pedretti, R. F E

AU - Braga, S. Sarzi

PY - 2002

Y1 - 2002

N2 - The identification of patients at higher risk of life-threatening ventricular arrhythmias after myocardial infarction still represents a clinically relevant problem, particularly after results of recent studies which support the efficacy of implantable cardioverter defibrillator (ICD) in reducing total mortality in patients with a previous myocardial infarction and left ventricular dysfunction, with and without additional risk markers. However, owing to the high cost of ICD therapy, an effective arrhythmic risk stratification may be desirable. The low diagnostic accuracy reported by various studies using single risk stratifiers (either invasive and non invasive) suggested a combined use of multiple parameters in order to improve the predictive power of the risk stratification algorithms. This approach, that takes into account the multifactorial genesis of malignant ventricular arrhythmias, has been demonstrated to be able to identify subgroups of patients at very high arrhythmic risk. In particular, a two-level algorithm based upon the selection of candidates to electrophysiologic study among patients with abnormal non-invasive testing, showed itself as a particularly effective tool for identification of such patients. In this paper the Authors summarize most recent results on the risk stratification protocols and the use of ICDs and provide an operative algorithm that keeps into account either aggressive and moderate approaches to patients surviving a myocardial infarction.

AB - The identification of patients at higher risk of life-threatening ventricular arrhythmias after myocardial infarction still represents a clinically relevant problem, particularly after results of recent studies which support the efficacy of implantable cardioverter defibrillator (ICD) in reducing total mortality in patients with a previous myocardial infarction and left ventricular dysfunction, with and without additional risk markers. However, owing to the high cost of ICD therapy, an effective arrhythmic risk stratification may be desirable. The low diagnostic accuracy reported by various studies using single risk stratifiers (either invasive and non invasive) suggested a combined use of multiple parameters in order to improve the predictive power of the risk stratification algorithms. This approach, that takes into account the multifactorial genesis of malignant ventricular arrhythmias, has been demonstrated to be able to identify subgroups of patients at very high arrhythmic risk. In particular, a two-level algorithm based upon the selection of candidates to electrophysiologic study among patients with abnormal non-invasive testing, showed itself as a particularly effective tool for identification of such patients. In this paper the Authors summarize most recent results on the risk stratification protocols and the use of ICDs and provide an operative algorithm that keeps into account either aggressive and moderate approaches to patients surviving a myocardial infarction.

KW - Impiantable cardioverter defibrillator

KW - Myocardial infarction

KW - Ventricular arrhythmias

UR - http://www.scopus.com/inward/record.url?scp=33750860446&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750860446&partnerID=8YFLogxK

M3 - Articolo

AN - SCOPUS:33750860446

VL - 58

SP - 42

EP - 46

JO - Monaldi Archives for Chest Disease

JF - Monaldi Archives for Chest Disease

SN - 1122-0643

IS - 1

ER -