Selection of patients eligible for implantable cardioverter defibrillator: beyond left ventricular ejection fraction

The selection of patients eligible for implantable cardioverter defibrillator (ICD), in primary prevention, is a critical moment in the management of the patients with cardiomyopathies as it needs a right balance of the patients' arrhythmic risk and the risks related to the implantation, as well as the device costs. Several data indicate that left ventricular ejection fraction alone is not a sufficient criterion for a proper identification of patients who could benefit most from ICD. Numerous findings show that genetic analysis and characterization of myocardial fibrosis with magnetic resonance imaging allow an important improvement of this process.

Automated summary

The selection of patients eligible for implantable cardioverter defibrillator (ICD) in primary prevention is crucial for the management of cardiomyopathy patients. It requires a careful evaluation of the patients' arrhythmic risk, implantation-related risks, and device costs. Left ventricular ejection fraction alone is insufficient for identifying patients who would benefit the most from ICD. Genetic analysis and characterization of myocardial fibrosis with magnetic resonance imaging have shown significant improvement in this process.