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Scarring of heart muscle may indicate need for ICD

Scarring of heart muscle may indicate need for ICD

Dilated cardiomyopathy patients with scarring of the heart may have an increased need for having an internal defibrillator (ICD), a new study has suggested.

At present decisions on whether an ICD is fitted are usually based on a patient’s left ventricular ejection fraction (a measure of how well blood is being pumped from the heart during each beat).

But a study by experts at the Royal Brompton Hospital and Imperial College in London showed that fibrosis may be a better predictor of risk of sudden death than ejection fraction The fibrosis was measured via magnetic resonance imaging (MRI).

The study, published on Tuesday in the Journal of the American Medical Association, followed 472 patients with dilated cardiomyopathy over eight years.

Analysis indicated that patients with fibrosis were around five times more at risk than those without it.

Professor Dudley Pennell, a Royal Brompton cardiologist, said: “ICDs can be an effective treatment to prevent risk of sudden death but we need much more evidence to know which patients would benefit from treatment.  ICDs don’t work for all patients. Our findings mean we can improve the selection of patients to have a device – saving lives and potentially 30 per cent in costs to the NHS for these patients.”

Senior lecturer Dr Sanjay Prasad said: “Our findings fill an important and significant gap in clinical knowledge about treating dilated cardiomyopathy. It has been challenging to determine in advance which patients would benefit most from a defibrillator – now we know that an MRI scan for each patient to look for the presence of fibrosis can provide essential information for determining effective treatment.”

by CMA Manager on 07-Mar-13 10:42

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The Cardiomyopathy Association's Registered Charity Number is 803262.
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