Sudden Cardiac Death Predicting the Future Risk Stratification for Sudden Cardiac Death in Patients With Left Ventricular Dysfunction

Risk stratification for any disease is, in many ways, medicine’s attempt to predict the future. The challenges in risk stratification for sudden death, however, may be unparalleled in medicine. Although the many types of sudden death all present with similar phenotypes, risk stratification efforts generally center on the prediction of death resulting from either ischemic or arrhythmic events. The focus of this article is on current and future approaches to risk stratification for sudden death caused by ventricular tachyarrhythmias in patients with left ventricular dysfunction (referred to here as sudden cardiac death [SCD]). Recent advances that limit the myocardial injury and remodeling that leads to left ventricular dysfunction continue to favorably affect SCD rates. However, the prevalence of SCD and the low survival rate once it occurs remain major public health concerns and underscore the importance of risk stratification and preemptive intervention.