Prediction and Management of People at High Risk of Sudden Death after Myocardial Infarction Who are not Covered by Guidelines

Abstract

The prevention of sudden cardiac death after myocardial infarction in contemporary clinical practice primarily relies on the evaluation of left ventricular ejection fraction (LVEF) . However, the single measurement is inadequate to identify people who are truly at high risk of sudden cardiac death. Based on the new clinical evidence that has been emerged in recent years, this review discussed the limitations of risk stratification for sudden death by LVEF, the exploration of early intervention in patients with high risk of sudden death after myocardial infarction, the re-stratification of patients with reduced LVEF for selecting the candidates who would benefit the most from implantable cardioverter defibrillator treatment, and the identification of patients with high risk of sudden death in those with preserved or slightly depressed LVEF. Furthermore, the paper reviewed the role of novel clinical scoring systems, cardiac magnetic resonance, noninvasive electrocardiography, and invasive electrophysiological testing in the prediction and management of sudden death.This review is expected to provide references for the long-term precise management and risk warning of patients with myocardial infarction.

Keywords

• |myocardial infarction|death, sudden, cardiac|forecasting|management|guidebooks