To implant or not to implant: Better risk stratification in ICD candidates

This thesis is part of the ongoing search for better risk stratification in implantable cardioverter defibrillator (ICD) candidates. ICD implantation is the treatment of choice to prevent sudden cardiac death (SCD) in patients with life-threatening ventricular arrhythmias (secondary prevention) and in patients with an increased risk for these ventricular arrhythmias (primary or prophylactic prevention). Despite the proved efficacy in preventing sudden cardiac death in patients with a high risk for ventricular arrhythmias and sudden cardiac death, we are still not able to identify accurately enough those patients who will or will not benefit from ICD implantation. Especially in patients with prophylactic ICD implantation, a minority of patients will receive appropriate device therapy during the first 5 years of follow-up. To reduce the number of unnecessary implantations, it is important to distinguish between patients who will and patients who will not benefit from ICD implantation.
The objectives of this thesis were to evaluate existing risk strategies and risk markers and to evaluate their use in daily practice.