SUDDEN-DEATH IN IDIOPATHIC DILATED CARDIOMYOPATHY - ROLE OF VENTRICULAR ARRHYTHMIAS

Sudden cardiac death (SCD) is associated with idiopathic congestive ca rdiomyopathy (IDCM) and most commonly is due to ventricular tachyarrhy thmias. The recurrence rate of SCD in the absence of specific therapy is thought to be around 20%-30% per year. Asymptomatic and symptomatic ventricular arrhythmias are common in patients with IDCM and the dire ct causal link of such arrhythmias with SCD in IDCM patients remains t o be established. Furthermore, therapy directed at suppressing these v entricular arrhythmias has not been shown to decrease the incidence of SCD. Various approaches such as ambulatory monitoring, electrophysiol ogical testing, signal-averaged electrocardiogram, and hemodynamics ha ve met with variable success in identifying patients prone to SCD. Add itionally, therapeutic approaches to prevent SCD in IDCM patients have produced equivocal results. This article reviews the published studie s addressing the causal link of ventricular arrhythmias to sudden deat h in patients with IDCM and the attempts to decrease the incidence of sudden.