Which Patients with Coronary Artery Disease Are Most Likely To Benefit from Primary Prevention of Cardiac Arrest?
The ideal risk factor is one that separates those persons destined to suffer cardiac arrest in the overall population (highly sensitive) from those who will not (highly specific). In addition, screening programs to detect these factors must be inexpensive and free from risk. Certain factors are consistently and independently associated with the highest risk for cardiac arrest. An ejection fraction of less than 0.40 is the single most important predictor of sudden cardiac death [1]. Frequent or complex ventricular ectopy, particularly after myocardial infarction, is also an important risk factor [6]. Figure 2 in the article by Myerburg and colleagues shows the interaction between ventricular ectopy and ejection fraction in generating increased risk in patients who have had a myocardial infarction. Despite the absence of definitive studies, programmed electrical stimulation (PES) of the heart to induce sustained ventricular tachycardia has been used both for risk stratification and for g
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