13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-235

Arrhythmic events and sudden death risk stratification in dilated cardiomyopathy

Gerardo Ansalone, Paolo Trambaiolo, Paride Giannantoni, Antonio Auriti, Fabrizio Ammirati, Susanna Franzin, Massimo Santini.
Cardiology Department of San Filippo Neri Hospital, Rome, Italy

Background

The challenge to prevent the sudden death (SD) in patients with idiopathic dilated cardiomyopathy (IDCM) has not yet been won, since the arrhythmic variables that are effective in post myocardial infarction risk stratification patients, lack specificity in predicting SD in this clinical setting, irrespective of the mechanism^1-7. This has motivated a search for other modalities that might provide improved prognostic information regarding SD risk in IDCM patients. When the arrhythmic stratification of IDCM patients is considered, the status of autonomic nervous system should be accurately evaluated with heart rate variability (HRV) analysis, which is the most common and non-invasive method for assessing the presence of an autonomic imbalance that may be a known triggering factor for lethal arrhythmias^8-15. In this article, we will explore the value of HRV measures and of asymptomatic non-sustained ventricular arrhythmias in the prediction of the risk of VT/VF and SD in patients with idiopathic dilated cardiomyopathy and advanced heart failure, that is focusing our attention on patients with heart failure without an obvious substrate for reentrant tachycardia due to prior myocardial infarction.