Natalia A Trayanova & Eric J Topol –

The incidence of sudden cardiac death is increasing globally, despite improvements in the prevention and management of ischaemic heart disease. The cornerstone for primary prevention of sudden cardiac death due to arrhythmia is the deployment of an implantable cardioverter-defibrillator (ICD). Although the survival benefit is indisputable, ICD therapy is resource-intensive and there are risks of complications and morbidity. Accurate risk assessment before device deployment is crucial. But assessment of left ventricular ejection fraction is insensitive. Thus, many patients are exposed to ICD risks without deriving any health benefit (90–95% of ICDs implanted are never utilised), whereas others are not protected, often dying suddenly in the prime of their life. Accordingly, accurate individualised risk assessment of sudden cardiac death is an unmet need.

Read the full article in The Lancet.