Sudden cardiac death other diagnostic studies: Difference between revisions

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(/* 2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death {{cite journal| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA | display-authors=etal| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. | journal=Eur Heart J | year= 2022 | volume= 43 | issue= 40 | pages= 3997-4126 | pmid=36017572 | doi=10.1093/eurheartj/ehac26...)
 
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=== Other Diagnostic Studies ===
__NOTOC__
*In survivors of [[sudden cardiac death]] due to lethal [[arrhythmia]] from [[ischemic heart disease]], [[coronary angiography]] and probable [[revascularization]] is recommended.<ref name="LemkesJanssens2020">{{cite journal|last1=Lemkes|first1=Jorrit S.|last2=Janssens|first2=Gladys N.|last3=van der Hoeven|first3=Nina W.|last4=Jewbali|first4=Lucia S. D.|last5=Dubois|first5=Eric A.|last6=Meuwissen|first6=Martijn M.|last7=Rijpstra|first7=Topm A.|last8=Bosker|first8=Hans A.|last9=Blans|first9=Michiel J.|last10=Bleeker|first10=Gabe B.|last11=Baak|first11=Remon R.|last12=Vlachojannis|first12=George J.|last13=Eikemans|first13=Bob J. W.|last14=van der Harst|first14=Pim|last15=van der Horst|first15=Iwan C. C.|last16=Voskuil|first16=Michiel|last17=van der Heijden|first17=Joris J.|last18=Beishuizen|first18=Albertus|last19=Stoel|first19=Martin|last20=Camaro|first20=Cyril|last21=van der Hoeven|first21=Hans|last22=Henriques|first22=Jose P.|last23=Vlaar|first23=Alexander P. J.|last24=Vink|first24=Maarten A.|last25=van den Bogaard|first25=Bas|last26=Heestermans|first26=Ton A. C. M.|last27=de Ruijter|first27=Wouter|last28=Delnoij|first28=Thijs S. R.|last29=Crijns|first29=Harry J. G. M.|last30=Jessurun|first30=Gillian A. J.|last31=Oemrawsingh|first31=Pranobe V.|last32=Gosselink|first32=Marcel T. M.|last33=Plomp|first33=Koos|last34=Magro|first34=Michael|last35=Elbers|first35=Paul W. G.|last36=Spoormans|first36=Eva M.|last37=van de Ven|first37=Peter M.|last38=Oudemans-van Straaten|first38=Heleen M.|last39=van Royen|first39=Niels|title=Coronary Angiography After Cardiac Arrest Without ST Segment Elevation|journal=JAMA Cardiology|volume=5|issue=12|year=2020|pages=1358|issn=2380-6583|doi=10.1001/jamacardio.2020.3670}}</ref>
{{Sudden cardiac death}}
{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}


*[[Electrophysiology study]] is recommended for induction of [[bradyarrhythmia]] ,[[ventricular tachyarrhythmia]], determination the indication for [[ICD]] implantation  in [[dilated cardiomyopathy]],[[ARVC]], [[HCM]].
==Overview==
*[[Electrophysiology study]] is not recommended in [[long QT syndrome]] ([[LQTS]]), [[cathecolaminergic polymorphic ventricular tachycardia]] ([[CPVT]]), [[short QTsyndrome]] ([[SQTS]])..<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>
There are several other diagnostic tests being done for [[sudden cardiac death]]. These include the [[signal-averaged electrocardiogram]] ([[SaECG]]), [[exercise testing]], provocative diagnostic tests such as the [[sodium channel blocker testing]], [[adenosine test]], and [[epinephrine test]], [[electrophysiology study]], and [[genetic testing]].
 
== Other Diagnostic Studies ==
 
There are several other diagnostic tests being done for [[sudden cardiac death]]. These include the [[signal-averaged electrocardiogram]] ([[SaECG]]), [[exercise testing]], provocative diagnostic tests such as the [[sodium channel blocker testing]], [[adenosine test]], and [[epinephrine test]], [[electrophysiology study]], and [[genetic testing]] <ref name="pmid18833586">{{cite journal| author=Goldberger JJ, Cain ME, Hohnloser SH, Kadish AH, Knight BP, Lauer MS | display-authors=etal| title=American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. | journal=Circulation | year= 2008 | volume= 118 | issue= 14 | pages= 1497-1518 | pmid=18833586 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18833586  }} </ref> <ref name="pmid29951136">{{cite journal| author=Gatzoulis KA, Arsenos P, Trachanas K, Dilaveris P, Antoniou C, Tsiachris D | display-authors=etal| title=Signal-averaged electrocardiography: Past, present, and future. | journal=J Arrhythm | year= 2018 | volume= 34 | issue= 3 | pages= 222-229 | pmid=29951136 | doi=10.1002/joa3.12062 | pmc=6010001 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29951136  }} </ref> <ref name="pmid20172912">{{cite journal| author=Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA | display-authors=etal| title=Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. | journal=Eur Heart J | year= 2010 | volume= 31 | issue= 7 | pages= 806-14 | pmid=20172912 | doi=10.1093/eurheartj/ehq025 | pmc=2848326 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20172912  }} </ref> <ref name="pmid30763784">{{cite journal| author=Giudicessi JR, Ackerman MJ| title=Exercise testing oversights underlie missed and delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia in young sudden cardiac arrest survivors. | journal=Heart Rhythm | year= 2019 | volume= 16 | issue= 8 | pages= 1232-1239 | pmid=30763784 | doi=10.1016/j.hrthm.2019.02.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30763784  }} </ref> <ref name="pmid33888264">{{cite journal| author=Roston TM, Kallas D, Davies B, Franciosi S, De Souza AM, Laksman ZW | display-authors=etal| title=Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia. | journal=JACC Clin Electrophysiol | year= 2021 | volume= 7 | issue= 4 | pages= 437-441 | pmid=33888264 | doi=10.1016/j.jacep.2021.02.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33888264  }} </ref> <ref name="pmid23994779">{{cite journal| author=Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C | display-authors=etal| title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. | journal=Europace | year= 2013 | volume= 15 | issue= 10 | pages= 1389-406 | pmid=23994779 | doi=10.1093/europace/eut272 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23994779  }} </ref> <ref name="pmid20962343">{{cite journal| author=Govindan M, Batchvarov VN, Raju H, Shanmugam N, Bizrah M, Bastiaenen R | display-authors=etal| title=Utility of high and standard right precordial leads during ajmaline testing for the diagnosis of Brugada syndrome. | journal=Heart | year= 2010 | volume= 96 | issue= 23 | pages= 1904-8 | pmid=20962343 | doi=10.1136/hrt.2010.201244 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20962343  }} </ref> <ref name="pmid30907461">{{cite journal| author=Churet M, Luttoo K, Hocini M, Haïssaguerre M, Sacher F, Duchateau J| title=Diagnostic reproducibility of epinephrine drug challenge interpretation in suspected long QT syndrome. | journal=J Cardiovasc Electrophysiol | year= 2019 | volume= 30 | issue= 6 | pages= 896-901 | pmid=30907461 | doi=10.1111/jce.13926 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30907461  }} </ref> <ref name="pmid1907984">{{cite journal| author=Bourke JP, Richards DA, Ross DL, Wallace EM, McGuire MA, Uther JB| title=Routine programmed electrical stimulation in survivors of acute myocardial infarction for prediction of spontaneous ventricular tachyarrhythmias during follow-up: results, optimal stimulation protocol and cost-effective screening. | journal=J Am Coll Cardiol | year= 1991 | volume= 18 | issue= 3 | pages= 780-8 | pmid=1907984 | doi=10.1016/0735-1097(91)90802-g | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1907984  }} </ref> <ref name="pmid25150471">{{cite journal| author=Gatzoulis KA, Tsiachris D, Arsenos P, Archontakis S, Dilaveris P, Vouliotis A | display-authors=etal| title=Prognostic value of programmed ventricular stimulation for sudden death in selected high risk patients with structural heart disease and preserved systolic function. | journal=Int J Cardiol | year= 2014 | volume= 176 | issue= 3 | pages= 1449-51 | pmid=25150471 | doi=10.1016/j.ijcard.2014.08.068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25150471  }} </ref> <ref name="pmid23588627">{{cite journal| author=Gatzoulis KA, Vouliotis AI, Tsiachris D, Salourou M, Archontakis S, Dilaveris P | display-authors=etal| title=Primary prevention of sudden cardiac death in a nonischemic dilated cardiomyopathy population: reappraisal of the role of programmed ventricular stimulation. | journal=Circ Arrhythm Electrophysiol | year= 2013 | volume= 6 | issue= 3 | pages= 504-12 | pmid=23588627 | doi=10.1161/CIRCEP.113.000216 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23588627  }} </ref> <ref name="pmid11816631">{{cite journal| author=Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY | display-authors=etal| title=Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. | journal=Pacing Clin Electrophysiol | year= 2001 | volume= 24 | issue= 11 | pages= 1623-30 | pmid=11816631 | doi=10.1046/j.1460-9592.2001.01623.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11816631  }} </ref> <ref name="pmid15358027">{{cite journal| author=Brembilla-Perrot B, Suty-Selton C, Beurrier D, Houriez P, Nippert M, de la Chaise AT | display-authors=etal| title=Differences in mechanisms and outcomes of syncope in patients with coronary disease or idiopathic left ventricular dysfunction as assessed by electrophysiologic testing. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 3 | pages= 594-601 | pmid=15358027 | doi=10.1016/j.jacc.2004.03.075 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15358027  }} </ref> <ref name="pmid11401129">{{cite journal| author=Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A | display-authors=etal| title=Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. | journal=J Am Coll Cardiol | year= 2001 | volume= 37 | issue= 7 | pages= 1901-7 | pmid=11401129 | doi=10.1016/s0735-1097(01)01246-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11401129  }} </ref> <ref name="pmid23994779">{{cite journal| author=Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C | display-authors=etal| title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. | journal=Europace | year= 2013 | volume= 15 | issue= 10 | pages= 1389-406 | pmid=23994779 | doi=10.1093/europace/eut272 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23994779  }} </ref> <ref name="pmid18281919">{{cite journal| author=Ingles J, Lind JM, Phongsavan P, Semsarian C| title=Psychosocial impact of specialized cardiac genetic clinics for hypertrophic cardiomyopathy. | journal=Genet Med | year= 2008 | volume= 10 | issue= 2 | pages= 117-20 | pmid=18281919 | doi=10.1097/GIM.0b013e3181612cc7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18281919  }} </ref> <ref name="pmid21787999">{{cite journal| author=Ackerman MJ, Priori SG, Willems S, Berul C, Brugada R, Calkins H | display-authors=etal| title=HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). | journal=Heart Rhythm | year= 2011 | volume= 8 | issue= 8 | pages= 1308-39 | pmid=21787999 | doi=10.1016/j.hrthm.2011.05.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21787999  }} </ref> <ref name="pmid33797288">{{cite journal| author=Conte G, Wilde A, Behr ER, Scherr D, Lenarczyk R, Gandjbachkh E | display-authors=etal| title=Importance of Dedicated Units for the Management of Patients With Inherited Arrhythmia Syndromes. | journal=Circ Genom Precis Med | year= 2021 | volume= 14 | issue= 2 | pages= e003313 | pmid=33797288 | doi=10.1161/CIRCGEN.120.003313 | pmc=8284353 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33797288  }} </ref>.
 
===Signal-averaged Electrocardiogram===
* [[Signal-averaged electrocardiogram]] ([[SaECG]]) is a [[diagnostic tool]] that detects very low amplitude signal leading to the identification of [[arrhythmogenic right ventricular cardiomyopathy]] ([[ARVC]]) <ref name="pmid29951136">{{cite journal| author=Gatzoulis KA, Arsenos P, Trachanas K, Dilaveris P, Antoniou C, Tsiachris D | display-authors=etal| title=Signal-averaged electrocardiography: Past, present, and future. | journal=J Arrhythm | year= 2018 | volume= 34 | issue= 3 | pages= 222-229 | pmid=29951136 | doi=10.1002/joa3.12062 | pmc=6010001 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29951136  }} </ref> <ref name="pmid20172912">{{cite journal| author=Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA | display-authors=etal| title=Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. | journal=Eur Heart J | year= 2010 | volume= 31 | issue= 7 | pages= 806-14 | pmid=20172912 | doi=10.1093/eurheartj/ehq025 | pmc=2848326 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20172912  }} </ref>.
 
===Exercise Testing===
* This test is useful in the [[diagnosis]] of [[exercise-induced idiopathic monomorphic ventricular tachycardia]] ([[MVT]]), [[paroxysmal ventricular tachycardia]] ([[PVT]]), and bidirectional [[ventricular tachycardia]] <ref name="pmid30763784">{{cite journal| author=Giudicessi JR, Ackerman MJ| title=Exercise testing oversights underlie missed and delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia in young sudden cardiac arrest survivors. | journal=Heart Rhythm | year= 2019 | volume= 16 | issue= 8 | pages= 1232-1239 | pmid=30763784 | doi=10.1016/j.hrthm.2019.02.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30763784  }} </ref> <ref name="pmid33888264">{{cite journal| author=Roston TM, Kallas D, Davies B, Franciosi S, De Souza AM, Laksman ZW | display-authors=etal| title=Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia. | journal=JACC Clin Electrophysiol | year= 2021 | volume= 7 | issue= 4 | pages= 437-441 | pmid=33888264 | doi=10.1016/j.jacep.2021.02.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33888264  }} </ref>.
 
===Provocative Diagnostic Tests===
* [[Intravenous]] [[diagnostic tests]] include [[ajmaline]], [[flecainide]], [[epinephrine]], [[acetylcholine]], [[ergonovine]], and [[adenosine]]. These tests are utilized to exclude latent pre-excitation <ref name="pmid23994779">{{cite journal| author=Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C | display-authors=etal| title=Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. | journal=Europace | year= 2013 | volume= 15 | issue= 10 | pages= 1389-406 | pmid=23994779 | doi=10.1093/europace/eut272 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23994779  }} </ref> <ref name="pmid20962343">{{cite journal| author=Govindan M, Batchvarov VN, Raju H, Shanmugam N, Bizrah M, Bastiaenen R | display-authors=etal| title=Utility of high and standard right precordial leads during ajmaline testing for the diagnosis of Brugada syndrome. | journal=Heart | year= 2010 | volume= 96 | issue= 23 | pages= 1904-8 | pmid=20962343 | doi=10.1136/hrt.2010.201244 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20962343  }} </ref>.
 
===Electrophysiology Study===
*This study includes measurement of programmed electrical stimulation (PES), baseline intervals ([[His-ventricuar interval]] and [[atrial-His interval]]) and [[electroanatomical mapping]] for [[diagnosis]] and [[therapy]] <ref name="pmid1907984">{{cite journal| author=Bourke JP, Richards DA, Ross DL, Wallace EM, McGuire MA, Uther JB| title=Routine programmed electrical stimulation in survivors of acute myocardial infarction for prediction of spontaneous ventricular tachyarrhythmias during follow-up: results, optimal stimulation protocol and cost-effective screening. | journal=J Am Coll Cardiol | year= 1991 | volume= 18 | issue= 3 | pages= 780-8 | pmid=1907984 | doi=10.1016/0735-1097(91)90802-g | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1907984  }} </ref> <ref name="pmid25150471">{{cite journal| author=Gatzoulis KA, Tsiachris D, Arsenos P, Archontakis S, Dilaveris P, Vouliotis A | display-authors=etal| title=Prognostic value of programmed ventricular stimulation for sudden death in selected high risk patients with structural heart disease and preserved systolic function. | journal=Int J Cardiol | year= 2014 | volume= 176 | issue= 3 | pages= 1449-51 | pmid=25150471 | doi=10.1016/j.ijcard.2014.08.068 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25150471  }} </ref> <ref name="pmid23588627">{{cite journal| author=Gatzoulis KA, Vouliotis AI, Tsiachris D, Salourou M, Archontakis S, Dilaveris P | display-authors=etal| title=Primary prevention of sudden cardiac death in a nonischemic dilated cardiomyopathy population: reappraisal of the role of programmed ventricular stimulation. | journal=Circ Arrhythm Electrophysiol | year= 2013 | volume= 6 | issue= 3 | pages= 504-12 | pmid=23588627 | doi=10.1161/CIRCEP.113.000216 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23588627  }} </ref> <ref name="pmid11816631">{{cite journal| author=Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY | display-authors=etal| title=Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. | journal=Pacing Clin Electrophysiol | year= 2001 | volume= 24 | issue= 11 | pages= 1623-30 | pmid=11816631 | doi=10.1046/j.1460-9592.2001.01623.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11816631  }} </ref> <ref name="pmid15358027">{{cite journal| author=Brembilla-Perrot B, Suty-Selton C, Beurrier D, Houriez P, Nippert M, de la Chaise AT | display-authors=etal| title=Differences in mechanisms and outcomes of syncope in patients with coronary disease or idiopathic left ventricular dysfunction as assessed by electrophysiologic testing. | journal=J Am Coll Cardiol | year= 2004 | volume= 44 | issue= 3 | pages= 594-601 | pmid=15358027 | doi=10.1016/j.jacc.2004.03.075 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15358027  }} </ref> <ref name="pmid11401129">{{cite journal| author=Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A | display-authors=etal| title=Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. | journal=J Am Coll Cardiol | year= 2001 | volume= 37 | issue= 7 | pages= 1901-7 | pmid=11401129 | doi=10.1016/s0735-1097(01)01246-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11401129  }} </ref>.
 
===Genetic testing===
* This test is used to identify [[genetic]] composition of an individual and determine whether genetic variation modifications are present leading to [[Brugada syndrome]], [[long QT syndrome]] ([[LQTS]]), [[hypertrophic cardiomyopathy]] ([[HCM]]), and [[dilated cardiomyopathy]] ([[DCM]]) <ref name="pmid33831308">{{cite journal| author=James CA, Jongbloed JDH, Hershberger RE, Morales A, Judge DP, Syrris P | display-authors=etal| title=International Evidence Based Reappraisal of Genes Associated With Arrhythmogenic Right Ventricular Cardiomyopathy Using the Clinical Genome Resource Framework. | journal=Circ Genom Precis Med | year= 2021 | volume= 14 | issue= 3 | pages= e003273 | pmid=33831308 | doi=10.1161/CIRCGEN.120.003273 | pmc=8205996 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33831308  }} </ref> <ref name="pmid32429735">{{cite journal| author=Lahrouchi N, Tadros R, Crotti L, Mizusawa Y, Postema PG, Beekman L | display-authors=etal| title=Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome. | journal=Circulation | year= 2020 | volume= 142 | issue= 4 | pages= 324-338 | pmid=32429735 | doi=10.1161/CIRCULATIONAHA.120.045956 | pmc=7382531 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32429735  }} </ref> <ref name="pmid33164571">{{cite journal| author=Wijeyeratne YD, Tanck MW, Mizusawa Y, Batchvarov V, Barc J, Crotti L | display-authors=etal| title=SCN5A Mutation Type and a Genetic Risk Score Associate Variably With Brugada Syndrome Phenotype in SCN5A Families. | journal=Circ Genom Precis Med | year= 2020 | volume= 13 | issue= 6 | pages= e002911 | pmid=33164571 | doi=10.1161/CIRCGEN.120.002911 | pmc=7748043 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33164571  }} </ref> <ref name="pmid33495597">{{cite journal| author=Harper AR, Goel A, Grace C, Thomson KL, Petersen SE, Xu X | display-authors=etal| title=Common genetic variants and modifiable risk factors underpin hypertrophic cardiomyopathy susceptibility and expressivity. | journal=Nat Genet | year= 2021 | volume= 53 | issue= 2 | pages= 135-142 | pmid=33495597 | doi=10.1038/s41588-020-00764-0 | pmc=8240954 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495597  }} </ref> <ref name="pmid33495596">{{cite journal| author=Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R | display-authors=etal| title=Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect. | journal=Nat Genet | year= 2021 | volume= 53 | issue= 2 | pages= 128-134 | pmid=33495596 | doi=10.1038/s41588-020-00762-2 | pmc=7611259 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495596  }} </ref> <ref name="pmid31504448">{{cite journal| author=Tadros R, Tan HL, ESCAPE-NET Investigators. El Mathari S, Kors JA, Postema PG | display-authors=etal| title=Predicting cardiac electrical response to sodium-channel blockade and Brugada syndrome using polygenic risk scores. | journal=Eur Heart J | year= 2019 | volume= 40 | issue= 37 | pages= 3097-3107 | pmid=31504448 | doi=10.1093/eurheartj/ehz435 | pmc=6769824 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31504448  }} </ref>.
 
 
==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA | display-authors=etal| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. | journal=Eur Heart J | year= 2022 | volume= 43 | issue= 40 | pages= 3997-4126 | pmid=36017572 | doi=10.1093/eurheartj/ehac262 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572  }} </ref>==
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Silver"|'''Recommendations for genetic testing'''''
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* [[Genetic testing]] is recommended when a condition is [[diagnosed]] in a living or deceased individual with a likely [[genetic]] basis and a risk of [[ventricular arrhythmia]] ([[VA]]), and [[sudden cardiac death]] ([[SCD]]).
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LightGreen"|
* When a putative causative variant is first identified evaluation for [[pathogenicity]] is recommended using an internationally accepted framework.
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LightGreen"|
* When a Class IV or Class V variant has been identified in a living or deceased individual with a condition that carries a risk of [[ventricular arrhythmia]] ([[VA]]) and [[sudden cardiac death]] ([[SCD]]), [[genetic testing]] of first-degree and [[symptomatic]] relatives and [[obligate carriers]] is recommended.
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LightGreen"|
*It is recommended that [[genetic testing]] and counseling on its potential consequences should be undertaken by an expert [[multidisciplinary team]].
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LightGreen"|
*It is recommended that class III (variants of uncertain significance) and Class IV [[variant]]s should be evaluated for segregation in [[families]] where possible, and the [[variant]] re-evaluated periodically.
|-
| colspan="1" style="text-align:center; background:Pink"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class III]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="Pink"|
*It is not recommended to undertake [[genetic testing]] in index [[patients]] with insufficiency evidence of a [[genetic disease]]. 
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Silver"|'''Recommendations for public basic life support and access to automated external defibrillators'''''
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* It is recommended that public access [[defibrillation]] be available at sites where [[cardiac arrest]] is more likely to occur.
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
*Prompt [[CPR]] by bystanders is recommended at out-of-hospital cardiac arrest.
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* It is recommended to promote [[community]] training in [[basic life support]] to increase bystander [[CPR]] rate and [[AED]] use.
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LemonChiffon"|
* Mobile phone-based alerting of [[basic life support]]-trained bystander volunteers to assist nearby out-of-hospital cardiac arrest victims should be considered.
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Silver"|'''Recommendations for diagnostic evaluation and general recommendations for ventricular arrhythmia in dilated cardiomyopathy/ hypo kinetic non-dilated cardiomyopathy'''''
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* [[Genetic testing]] (including at least LMNA, PLN, RBM20, and FLNC [[genes]]) is recommended in [[patients]] with [[dilated cardiomyopathy]] ([[DCM]])/ [[hyopkinetic non-dilated cardiomyopathy]] ([[HNDCM]]) and [[atrioventricular]] ([[AV]]) conduction delay at <50 years or who have a [[family history]] of [[DCM]]/[[HNDCM]] or [[sudden cardiac death]] ([[SCD]]) in a [[first-degree relative]] (at [[age]] < 50 years.
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LemonChiffon"|
* [[Genetic testing]] (including at least LMNA, PLN, RBM20, and FLNC [[genes]]) should be considered for [[risk stratification]] in [[patients]] with apparently [[sporadic]] [[DCM]]/[[HNDCM]], who present at [[young age]], or with [[signs]] suspicious for an [[inherited]] [[etiology]].
|-
| colspan="1" style="text-align:center; background:Pink"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class III]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="Pink"|
* Participation in [[high-intensity exercise]] including competitive sports is not recommended for individuals with [[DCM]]/[[HNDCM]] and a [[LMNA]] [[mutation]].
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Silver"|'''Recommendations for diagnosis of ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy'''''
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* In [[patients]] with a suspected or [[definite diagnosis]] of [[arrhythmogenic right ventricular cardiomyopathy]] ([[ARVC]]), [[genetic counselling and testing]] are recommended.
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* Avoidance of [[high-intensity exercise]] is recommended in [[patients]] with a [[definite diagnosis]] of [[ARVC]].
|-
| colspan="1" style="text-align:center; background:Orange"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class IIb]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="LightGreen"|
* Avoidance of [[high-intensity exercise]] may be considered in [[carriers]] of [[ARVC]]-related [[pathogenic]] [[mutations]] and no [[phenotype]].
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Silver"|'''Recommendations for diagnosis of ventricular arrhythmias in hypertrophic cardiomyopathy'''''
|-
| colspan="1" style="text-align:center; background:LightGreen"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])'''''
|-
| bgcolor="LightGreen"|
* [[Genetic counseling and testing]] are recommended in [[HCM]] [[patients]].
|-
| colspan="1" style="text-align:center; background:Orange"|'''[[2022 ESC Guidelines Classification Scheme#Classification of Recommendations|Class IIb]] ''([[2022 ESC Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
|-
| bgcolor="Orange"|
* Participation in [[high-intensity exercise]] may be considered for [[asymptomatic]] [[adult]] [[HCM]] [[patients]] without [[risk markers]].
|}
 
==2017AHA/ACC/HRS Guideline for management of [[sudden cardiac arrest]] and [[ventricular arrhythmia]]==
<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background: Pink"|[[AHA guidelines classification scheme#Classification of Recommendations|'''Class I, Level of evidence: B''']]
|-
|bgcolor="Pink"|In patients who recovered from [[SCA]] due to [[ventricular arrhythmia]] suspected [[ischemic heart disease]], [[coronary angiography]] and probabley revascularization is recommmended
|-
| colspan="1" style="text-align:center; background:Pink"|[[AHA guidelines classification scheme#Classification of Recommendations|'''Class I, Level of evidence:C''']]
|-
|bgcolor="Pink"|In patients with anomalous origin of a [[coronary artery]] leading [[ventricular arrhythmia]] or [[SCA]], repair or revascularization is recommended
|-
|}
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[AHA guidelines classification scheme#Classification of Recommendations|'''Class IIa, Level of evidence: B''']]
|-
|bgcolor="LemonChiffon"|In patients with ischemic or [[nonischemic]] [[cardiomyopathy]] or [[congenital heart disease]] presented with [[syncope]] arrhythmia and do not meet criteria for  primary prevention ICD, an electrophysiological study is recommended for assessing the risk of sustained [[VT]]
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[AHA guidelines classification scheme#Classification of Recommendations|'''Class III, Level of evidence: B''']]
|-
|bgcolor="LemonChiffon"|In patients who meet criteria for [[ICD]] implantation, an [[electrophysiological study]] is not recommended for only inducing [[ventricular arrhythmia]]
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[AHA guidelines classification scheme#Classification of Recommendations|'''Class III, Level of evidence: B''']]
|-
|bgcolor="LemonChiffon"| An electrophysiological study is not recommended for risk stratification  for [[ventricular arrhythmia]] in patients with [[Long QT syndrome]], [[short QT syndrome]], [[cathecolaminergic polymorphic  ventricular arrhythmia]]
|-
|}
 
 
 
 
 
 
 
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:PapayaWhip"|'''[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])'''''
 
|-
| bgcolor="PapayaWhip"|
* In patients with [[SCA]] or [[SCD]] in their family member, genetic tests and genetic counselling is recommended
|}
 
==References==
{{reflist|2}}
 
{{WH}}
{{WS}}

Latest revision as of 18:16, 22 July 2023

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Edzel Lorraine Co, DMD, MD[3]

Overview

There are several other diagnostic tests being done for sudden cardiac death. These include the signal-averaged electrocardiogram (SaECG), exercise testing, provocative diagnostic tests such as the sodium channel blocker testing, adenosine test, and epinephrine test, electrophysiology study, and genetic testing.

Other Diagnostic Studies

There are several other diagnostic tests being done for sudden cardiac death. These include the signal-averaged electrocardiogram (SaECG), exercise testing, provocative diagnostic tests such as the sodium channel blocker testing, adenosine test, and epinephrine test, electrophysiology study, and genetic testing [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [6] [15] [16] [17].

Signal-averaged Electrocardiogram

Exercise Testing

Provocative Diagnostic Tests

Electrophysiology Study

Genetic testing


2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death [24]

Recommendations for genetic testing
Class I (Level of Evidence: B)
Class I (Level of Evidence: C)
  • When a putative causative variant is first identified evaluation for pathogenicity is recommended using an internationally accepted framework.
Class I (Level of Evidence: C)
Class I (Level of Evidence: C)
Class I (Level of Evidence: C)
  • It is recommended that class III (variants of uncertain significance) and Class IV variants should be evaluated for segregation in families where possible, and the variant re-evaluated periodically.
Class III (Level of Evidence: C)
Recommendations for public basic life support and access to automated external defibrillators
Class I (Level of Evidence: B)
Class I (Level of Evidence: B)
  • Prompt CPR by bystanders is recommended at out-of-hospital cardiac arrest.
Class I (Level of Evidence: B)
Class IIa (Level of Evidence: B)
  • Mobile phone-based alerting of basic life support-trained bystander volunteers to assist nearby out-of-hospital cardiac arrest victims should be considered.
Recommendations for diagnostic evaluation and general recommendations for ventricular arrhythmia in dilated cardiomyopathy/ hypo kinetic non-dilated cardiomyopathy
Class I (Level of Evidence: B)
Class IIa (Level of Evidence: C)
Class III (Level of Evidence: C)
Recommendations for diagnosis of ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy
Class I (Level of Evidence: B)
Class I (Level of Evidence: B)
Class IIb (Level of Evidence: C)
Recommendations for diagnosis of ventricular arrhythmias in hypertrophic cardiomyopathy
Class I (Level of Evidence: B)
Class IIb (Level of Evidence: C)

2017AHA/ACC/HRS Guideline for management of sudden cardiac arrest and ventricular arrhythmia

[25]

Class I, Level of evidence: B
In patients who recovered from SCA due to ventricular arrhythmia suspected ischemic heart disease, coronary angiography and probabley revascularization is recommmended
Class I, Level of evidence:C
In patients with anomalous origin of a coronary artery leading ventricular arrhythmia or SCA, repair or revascularization is recommended
Class IIa, Level of evidence: B
In patients with ischemic or nonischemic cardiomyopathy or congenital heart disease presented with syncope arrhythmia and do not meet criteria for primary prevention ICD, an electrophysiological study is recommended for assessing the risk of sustained VT
Class III, Level of evidence: B
In patients who meet criteria for ICD implantation, an electrophysiological study is not recommended for only inducing ventricular arrhythmia
Class III, Level of evidence: B
An electrophysiological study is not recommended for risk stratification for ventricular arrhythmia in patients with Long QT syndrome, short QT syndrome, cathecolaminergic polymorphic ventricular arrhythmia




Class I (Level of Evidence: C)
  • In patients with SCA or SCD in their family member, genetic tests and genetic counselling is recommended

References

  1. Goldberger JJ, Cain ME, Hohnloser SH, Kadish AH, Knight BP, Lauer MS; et al. (2008). "American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention". Circulation. 118 (14): 1497–1518. PMID 18833586.
  2. 2.0 2.1 Gatzoulis KA, Arsenos P, Trachanas K, Dilaveris P, Antoniou C, Tsiachris D; et al. (2018). "Signal-averaged electrocardiography: Past, present, and future". J Arrhythm. 34 (3): 222–229. doi:10.1002/joa3.12062. PMC 6010001. PMID 29951136.
  3. 3.0 3.1 Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA; et al. (2010). "Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria". Eur Heart J. 31 (7): 806–14. doi:10.1093/eurheartj/ehq025. PMC 2848326. PMID 20172912.
  4. 4.0 4.1 Giudicessi JR, Ackerman MJ (2019). "Exercise testing oversights underlie missed and delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia in young sudden cardiac arrest survivors". Heart Rhythm. 16 (8): 1232–1239. doi:10.1016/j.hrthm.2019.02.012. PMID 30763784.
  5. 5.0 5.1 Roston TM, Kallas D, Davies B, Franciosi S, De Souza AM, Laksman ZW; et al. (2021). "Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia". JACC Clin Electrophysiol. 7 (4): 437–441. doi:10.1016/j.jacep.2021.02.013. PMID 33888264 Check |pmid= value (help).
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