Cardiac Magnetic Resonance for Prophylactic Implantable-Cardioverter Defibrillator Therapy in Ischemic Cardiomyopathy

• Published in: JACC. Cardiovascular imaging 2023-11, Vol.16 (11), p.1387-1400
• Main Authors: Pontone, Gianluca, Guaricci, Andrea Igoren, Fusini, Laura, Baggiano, Andrea, Guglielmo, Marco, Muscogiuri, Giuseppe, Volpe, Alessandra, Abete, Raffaele, Aquaro, Giovanni, Barison, Andrea, Bogaert, Jan, Camastra, Giovanni, Carigi, Samuela, Carrabba, Nazario, Casavecchia, Grazia, Censi, Stefano, Cicala, Gloria, De Cecco, Carlo N., De Lazzari, Manuel, Di Giovine, Gabriella, Di Roma, Mauro, Dobrovie, Monica, Focardi, Marta, Gaibazzi, Nicola, Gismondi, Annalaura, Gravina, Matteo, Lanzillo, Chiara, Lombardi, Massimo, Lorenzoni, Valentina, Lozano-Torres, Jordi, Martini, Chiara, Marzo, Francesca, Masi, Ambra, Memeo, Riccardo, Moro, Claudio, Nese, Alberto, Palumbo, Alessandro, Pavon, Anna Giulia, Pedrotti, Patrizia, Marra, Martina Perazzolo, Pica, Silvia, Pradella, Silvia, Presicci, Cristina, Rabbat, Mark G., Raineri, Claudia, Rodriguez-Palomares, José F., Sbarbati, Stefano, Schoepf, U. Joseph, Squeri, Angelo, Sverzellati, Nicola, Symons, Rolf, Tat, Emily, Timpani, Mauro, Todiere, Giancarlo, Valentini, Adele, Varga-Szemes, Akos, Masci, Pier-Giorgio, Schwitter, Juerg
• Format: Article
• Language: English
• Subjects: cardiac magnetic resonance; heart failure; implantable cardioverter-defibrillator; ischemic dilated cardiomyopathy; primary prevention
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2023.03.015

Implantable cardioverter-defibrillator (ICD) therapy is the most effective prophylactic strategy against sudden cardiac death (SCD) in patients with ischemic cardiomyopathy (ICM) and left ventricle ejection fraction (LVEF) ≤35% as detected by transthoracic echocardiograpgy (TTE). This approach has been recently questioned because of the low rate of ICD interventions in patients who received implantation and the not-negligible percentage of patients who experienced SCD despite not fulfilling criteria for implantation. The DERIVATE (CarDiac MagnEtic Resonance for Primary Prevention Implantable CardioVerter DebrillAtor ThErapy)-ICM registry (NCT03352648) is an international, multicenter, and multivendor study to assess the net reclassification improvement (NRI) for the indication of ICD implantation by the use of cardiac magnetic resonance (CMR) as compared to TTE in patients with ICM. A total of 861 patients with ICM (mean age 65 ± 11 years, 86% male) with chronic heart failure and TTE-LVEF