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Sudden Cardiac Death

Proven Therapy for Patients at Early Risk of Sudden Cardiac Death

The risk of sudden cardiac death (SCD) or life threatening arrhythmias is notably elevated in patients with newly diagnosed heart failure and reduced ejection fraction in the first 90 days after diagnosis.1,2 Clinical trials have shown that the clinical condition of patients often fluctuates during this period.3 Therefore, optimised guideline recommended medical therapy (GRMT) is crucial before considering further long-term therapies such as implantable cardioverter defibrillator (ICD) implantation.4-5 This reflects the outcome of recent clinical trials, that Reverse Remodeling processes take time despite modern drug therapy.6-7 

 

Section Advisor: Prof Christian Perings

Prof Christian Perings

 

 

 

 

 

 

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Featured Video

Guideline-directed Management of Patients at Risk of Sudden Cardiac Death

In this short interview, conducted at ESC 2022 in Barcelona, Prof David Duncker (Hannover Heart Rhythm Center, Hannover, DE) discusses the relevancy of sudden cardiac death risk, how the recent ESC guidelines protect patients, and considers recommendations for risk stratification.

Discussion topics:

1. Relevancy of sudden cardiac death risk

2. The recently published ESC guidelines

3. Recommendations for risk stratification

 

Location: ESC 2022, Barcelona, ES
Interviewer: Jonathan McKenna
ESC HFA 25: SCD-PROTECT: SCD in New Non-ischemic Cardiomyopathy or MI/CAD

ESC HF 25 - SCD-PROTECT shows high risk of sudden cardiac arrest (SCA) and sudden cardiac death (SCD) during early medical therapy optimization for reduced LVEF in patients with new non-ischemic cardiomyopathy or MI/CAD.

 

Recorded on-site at ESC HF in Belgrade, 2025.
Editors: Jonathan McKenna
Videographer: Tom Green, Mike Knight
Support: This is an independent interview produced by Radcliffe Cardiology

Further Reading and References

Further Reading

Left-ventricular ejection fraction (LVEF) remains the most relevant predictor of SCD risk.1 According to the most recent guidelines from the European Society of Cardiology (ESC), patients with an LVEF ≤ 35% after an acute cardiac event could be considered for a wearable cardioverter defibrillator (WCD; LifeVest® ZOLL CMS) during the drug therapy optimisation phase.4-5,8 This recommendation is consistent with previous guidelines and is supported by extensive evidence, including data from over 20,000 patients from both retrospective and prospective registries, along with findings from large randomised controlled trials, highlighting the clinical effectiveness of the WCD in terminating ventricular tachyarrhythmias.1,7-13 The median WCD daily wearing time in recent studies and registries exceeds 22 hours.9-15


LifeVest WCD serves as a treatment option for patients with transient risk of SCD, offering advanced protection and monitoring during the early post-cardiac event phase while medical therapy is optimised and permanent risk is assessed. Unlike an ICD, LifeVest is worn outside the body rather than implanted in the chest. It is designed to continuously monitor a patient’s heart, detecting certain life-threatening rapid heart rhythms and automatically deliver a treatment shock to restore normal heart rhythm.

References

1. Olgin JE, et al. N Engl J Med 2018;379:1205–15.
2. Solomon SD, et al. N Engl J Med 2005;352:2581–8.
3. Kutyifa V, et al. Circulation 2015;132:1613–9.
4. McDonagh T, et al. Eur H J 2021;36:3599–726.
5. Zeppenfeld K, et al. Eur H J 2022;43:3997–4126.
6. Veltmann C, et al. Eur H J 2024;00:1–11.
7. Januzzi JL, et al. JAMA 2019;322:1085–95.
8. McDonagh T, et al. Eur H J 2023;37:3627–39.
9. Epstein AE, et al. JACC 2013;62:2000–7.
10. Wäßnig NK, et al. Circulation 2016;134:635–43.
11. Nguyen E, et al. J Innov Card Rhythm Manag 2018;9:3151–62.
12. Mueller-Leisse J, et al. ESC Heart Fail. 2021;8:5142–8.
13. Garcia R, et al. EP Europace 2021;23:73–81.
14. Odeneg T, et al. Eur J of Card Nurs 2019;18:75–83.
15. Kovacs B, et al. Swiss Med Wkly 2020;150:w20343.