Treatment of Alcohol-induced Cardiomyopathy in Dilated Cardiomyopathy with a Genotype Linked to High Sudden Cardiac Death Risk

This protocol applies when alcohol-induced cardiomyopathy occurs alongside dilated cardiomyopathy (DCM) in a patient who carries a genotype associated with high sudden cardiac death (SCD) risk, has a left ventricular ejection fraction (LVEF) above 35%, and has one or more qualifying additional risk factors present.

Clinical Scenario

Dilated cardiomyopathy (DCM)
Genotype associated with high sudden cardiac death risk
Left ventricular ejection fraction (LVEF) >35%
At least one additional risk factor: syncope or late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR)

Treatment Approach

Given the combination of a high-risk genotype and the additional risk factors described above, guidelines support a specific device-based intervention targeting the arrhythmic risk in this population. The complete structured regimen — including the precise intervention and all clinical considerations — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehad194

An ICD should be considered in patients with DCM with a genotype associated with high SCD risk and LVEF >35% in the presence of additional risk factors (see Table 21).

Additional risk factors include syncope, LGE presence on CMR.

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