Sudden cardiac death in nonischemic cardiomyopathy

Rikin S. Kadakia, Mark S. Link, Paari Dominic, Daniel P. Morin

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


Sudden cardiac death (SCD) is a major cause of mortality in patients with nonischemic cardiomyopathy (NICM). Identifying patients who are at highest risk for SCD is an ongoing challenge. At present, guidelines recommend the use of an implantable cardioverter-defibrillator (ICD) in patients with NICM with a reduced left ventricular ejection fraction (LVEF) and heart failure (HF) symptoms. Some recent data, however, suggest that ICDs may not increase longevity in this population. Conversely, community-based studies have demonstrated that many at-risk individuals who may benefit from ICD therapy remain unprotected. Current recommendations for ICD implantation are continually debated, justifying comprehensive individualized risk assessment. Various promising techniques for further risk stratification are under evaluation, including cardiac magnetic resonance imaging, electrocardiographic assessment of electrical instability, and genetic testing. However, none of these strategies has been fully adapted into guidelines. Hence, clinical risk stratification practice today depends on LVEF and HF symptoms, which have poor sensitivity and specificity for predicting SCD risk.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalProgress in Cardiovascular Diseases
Issue number3
StatePublished - May 1 2019


  • Implantable cardioverter-defibrillator
  • Nonischemic cardiomyopathy
  • Risk stratification
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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