The Open Cardiovascular Imaging Journal

2013, 4 : 1-3
Published online 2013 June 26. DOI: 10.2174/1876533520130603001
Publisher ID: TOCARIJ-4-1

ICD in Primary Prevention: Potential Role of Sympathetic Nerve Imaging

Testa Marzia MD , Garnero Sonia , Avogadri Enrico MD , Lombardo Enrico MD , Piccolo Salvatore MD , Biggi Alberto MD , Chauvie Stephane MD and Feola Mauro MD FESC
Department of Cardiovascular Rehabilitation-Heart Failure Unit, Ospedale SS Trinita', Via Ospedale 4 12045 Fossano (CN) Italy.

ABSTRACT

Patients with chronic heart failure (CHF) and left ventricular ejection fraction (LVEF) ≤ 35% are at increased risk for sudden cardiac death (SCD). These patients are likely to receive an implantable cardioverter defibrillator (ICD), effective in reducing the occurrence of SCD in primary prevention. The decision to use an ICD in CHF, according to the current guidelines, is based on New York Heart Association classification (NYHA) of II or III and a LVEF ≤ 35%, but reduced LVEF is a nonspecific predictor of potentially fatal arrhythmic events. Many studies have shown that a (123)Imetaiodobenzylguanidine ((123)I-MIBG) scintigraphy, which identifies sympathetic nervous system dysfunction, is useful for determining the prognosis in CHF patients. This case report describes the potential role of (123)I-MIBG into the decision-making process for ICD placement, improving the accuracy in the selection of patients most likely to benefit from an ICD implantation.

Keywords:

Primary prevention ICD, congestive heart failure, MIBG myocardial scintigraphy.