Arrhythmic risk stratification in ischemic,non-ischemic and hypertrophic cardiomyopathy:A two-step multifactorial,electrophysiology study inclusive approach  

作　　者：Petros Arsenos Konstantinos A Gatzoulis Dimitrios Tsiachris Polychronis Dilaveris Skevos Sideris Ilias Sotiropoulos Stefanos Archontakis Christos-Konstantinos Antoniou Athanasios Kordalis Ioannis Skiadas Konstantinos Toutouzas Charalambos Vlachopoulos Dimitrios Tousoulis Konstantinos Tsioufis 

机构地区：[1]First Department of Cardiology,National and Kapodistrian University of Athens,Hippokration Hospital,Athens 11527,Attika,Greece [2]Athens Heart Center,Athens Medical Center,Athens 15125,Attika,Greece [3]Department of Cardiology,Hippokration Hospital,Athens 11527,Attika,Greece [4]Fifth Department of Cardiology,Hygeia Hospital,Marousi 15123,Attika,Greece

出　　处：《World Journal of Cardiology》2022年第3期139-151,共13页世界心脏病学杂志（英文版）（电子版）

摘　　要：Annual arrhythmic sudden cardiac death ranges from 0.6%to 4%in ischemic cardiomyopathy(ICM),1%to 2%in non-ischemic cardiomyopathy(NICM),and 1%in hypertrophic cardiomyopathy(HCM).Towards a more effective arrhythmic risk stratification(ARS)we hereby present a two-step ARS with the usage of seven non-invasive risk factors:Late potentials presence(≥2/3 positive criteria),premature ventricular contractions(≥30/h),non-sustained ventricular tachycardia(≥1episode/24 h),abnormal heart rate turbulence(onset≥0%and slope≤2.5 ms)and reduced deceleration capacity(≤4.5 ms),abnormal T wave alternans(≥65μV),decreased heart rate variability(SDNN<70ms),and prolonged QT_(c)interval(>440 ms in males and>450 ms in females)which reflect the arrhythmogenic mechanisms for the selection of the intermediate arrhythmic risk patients in the first step.In the second step,these intermediate-risk patients undergo a programmed ventricular stimulation(PVS)for the detection of inducible,truly high-risk ICM and NICM patients,who will benefit from an implantable cardioverter defibrillator.For HCM patients,we also suggest the incorporation of the PVS either for the low HCM Risk-score patients or for the patients with one traditional risk factor in order to improve the inadequate sensitivity of the former and the low specificity of the latter.

关 键 词：Arrhythmic sudden cardiac death Risk stratification Non-invasive risk factors Electrophysiology study Two-step approach Arrhythmias in cardiomyopathy 

分 类 号：R541.7[医药卫生—心血管疾病] R542.2[医药卫生—内科学]