Neelanjana Pandey, Niel Shah and Timothy J Vittorio
Sudden cardiac death (SCD) remains a major public health burden. There are numerous invasive and noninvasive techniques to identify patients at risk for SCD. The most commonly used parameter for assessment is left ventricular ejection fraction (LVEF) but there is considerable interest in using cardiac biomarkers that reflect arrhythmogenic substrates more directly and hence enrich the prediction of SCD events. This reasoning results from community-based studies demonstrating that 70-75% of all SCD cases have either normal or mild to moderately decreased left ventricular (LV) systolic function. Thus, there is a critical need for novel biomarkers to be identified and utilized. The complex nature of a SCD phenotype demands an integrated and interdisciplinary approach for identification of early risk predictors. The newer tools should be adequately innovative either to complement or to replace the currently available tools like invasive electrophysiological testing which is often used to identify patient populations with ischemic heart disease (IHD) who are at an increased risk for SCD and therefore may benefit from automatic implantable cardioverter defibrillator (AICD) therapy. Here in this mini-review, we provide a brief synopsis of the progress made in SCD risk stratification.
