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Predicting and Preventing Sudden Cardiac Death in Patients Without Systolic Dysfunction

Cardiology University of Washington via YouTube

Overview

Explore a comprehensive 59-minute grand rounds lecture on predicting and preventing sudden cardiac death in patients without systolic dysfunction. Delve into current challenges in sudden cardiac death prevention, potential future solutions, and the importance of considering competing risks in risk stratification. Examine racial and sex differences in sudden cardiac death incidence, causes, and mechanisms. Learn about primary prevention strategies, including ICD trials and wearable defibrillators. Investigate biomarkers, genetic factors, and ECG measures for risk assessment in general populations. Analyze the PRE-DETERMINE cohort study and its findings on risk prediction in patients without severe systolic dysfunction. Understand the impact of age and competing risks on ICD benefit and patient selection. Discover how ECG and polygenic risk scores can enhance risk stratification in coronary heart disease patients. Gain insights into the challenges and future directions for reducing sudden cardiac death mortality beyond low LVEF populations.

Syllabus

Intro
Sudden Cardiac Death and Out-of-Hospital Cardiac Arrest
Racial and Sex Differences in Sudden Cardiac Death: The REGARDS Study
Lifetime Cumulative Incidence of SCD in ARIC by Race and Sex groups
Causes of Sudden Cardiac Death
Prospective Autopsy Characterization of Sudden Cardiac Death in San Francisco County: POST SCD Study
Mechanism of Sudden Cardiac Death
Proportion of EMS treated Cardiac Arrests with VF as Initial Rhythm in Seattle, USA
Treatment: Cardiopulmonary Resuscitation and Defibrillation
First Documented Cardiac Rhythm in Witnessed Arrests/ROC Epistry-Cardiac Arrest
Future Approaches to Resuscitation
Current Approach to SCD Prevention
Primary Prevention of SCD: ICD Trials
Wearable Defibrillator after Acute MI: The VEST Trial
LV Dysfunction and ICD Utilization after MI:Pre-SCD II Registry
Paradigm HF
LVEF and SCD Implications for Prevention and ICD Utilization
Estimating Myocardial Infarction Size With a Simple Electrocardiographic Marker Score
Arrhythmic Sudden Death Survival Prediction using Deep Learning Analysis of MRI SCAR in CHD
Biomarkers and SCD in the General Population
Replication of Biomarkers in the Population: Harvard SCD Consortium
Additive Value of Biomarkers on SCD Risk
Familial Aggregation of SCD
GWAS of Sudden Cardiac Arrest in General Population
Genetic Risk Scores and Sudden Cardiac Arrest: Mendelian Randomization
Rare Sequence Variation and SCD Exome Sequencing
Characteristics of SCD cases and controls
Filtration and Classification of Variants identified by Exome Sequencing
Pathogenic or Likely Pathogenic Variants in MESA Population
ECG Measures and SCD Risk General Population Studies
Absolute Incidence of SCD across High and Low Risk Populations
SCD Prevention in General Populations: Healthy Lifestyle and SCD
Sudden Death in HFPEF - TOPCAT Trial
PRE-DETERMINE Cohort Study (R01HL091069)SCD Risk Prediction in Patients without Severe Systolic Dysfunction
PREDETERMINE Baseline Characteristics
LVEF and Mode of Death in PRE-DETERMINE
Differential Association of Clinical Risk Factors With Sudden and/or Arrhythmic Death (SAD) vs. Competing Modes of Death
Age and Risk of Sudden and/or Arrhythmic Death (SAD) vs. Competing Modes of Death
Potential Impact of Absolute Risk on ICD Benefit: Number Needed to Treat (NNT) to Save One Life
Competing Risks and ICD Benefit: Proportional SAD Risk and Percent Mortality Reduction
DANISH TRIAL: IMPACT OF AGE ON COMPETING RISK
Importance of Competing Risk in Selecting Candidates for ICD Therapy
The ECG Stratifies SCD in Coronary Heart Disease Patients PREDETERMINE and ARTEMIS
Polygenic Risk Score (PRS) for CAD Specifically Predicts SAD in PREDETERMINE
Polygenic Risk Score (PRS): Additive SAD Risk Prediction to Clinical Factors and ECG
Summary: Challenges to Reducing Mortality from Sudden Cardiac Death
The Next Frontier: Moving Beyond the Low LVEF Population

Taught by

Cardiology University of Washington

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