Late gadolinium enhancement is a strong predictor of life threatening arrhythmias in patients with dilated cardiomyopathy undergoing ICD implantation for primary prevention of sudden cardiac death

Abstract Background The usefulness of implantable cardioverter defibrillators (ICD) for primary prevention arrhythmic sudden cardiac death (SCD) in patients with non-ischemic dilated cardiomyopathy (DCM) has been questioned. Efforts to improve risk stratification have included scores such as the “MADIT-ICD benefit score”, and use late gadolinium enhancement (LGE) magnetic resonance (CMR). purpose this study was evaluate potential these two tools assess life-threatening arrhythmias DCM undergoing ICD implantation SCD. Methods We conducted a single-center retrospective consecutive who underwent contrast-enhanced CMR before Patients ischemic were used reference. non-dilated cardiomyopathies excluded. component MADIT-ICD score (VT/VF score) calculated each patient, considered high if ≥7, recommended. endpoint occurrence SCD or (VF VT >200 bpm). Follow-up performed by device interrogation all except those suffered Results A total 151 (93 ischemic, mean age 62±13 years, 75% male) left ventricular ejection fraction (LVEF) 27±8% included. Overall, 72% (n=67) 45% (n=26) had ≥7 high-risk. LGE present cardiomyopathy, 76% (n=44) DCM. During median follow-up 21 (8–38) months, (13.9%, 11 10 non-ischemic) met endpoint. event-free survival similar that (log rank p=0.269). In DCM, there 7 events (26.9%) VT/VF 3 (9.4%) <7 p=0.104). same population, (23%) LGE, but no without p=0.036). LVEF (26±8% vs. 27±7%, p=0.717), (26±7% 28±9%, p=0.342). Conclusion presence is strong predictor life threatening prevention, seemingly outperforming clinical score. Funding Acknowledgement Type funding sources: None.