Dilated Cardiomyopathy with High SCD-Risk Genotype and Left Ventricular Ejection Fraction >35%: What Treatment Is Indicated?

Clinical Scenario

This protocol addresses patients with dilated cardiomyopathy (DCM) who carry a genotype associated with high sudden cardiac death (SCD) risk and have a left ventricular ejection fraction (LVEF) above 35%, along with at least one additional risk factor — specifically syncope or late gadolinium enhancement (LGE) detected on cardiac magnetic resonance (CMR) imaging.

Treatment Approach

The evidence-based approach for this specific combination of genotypic and clinical risk factors involves a device-based intervention aimed at reducing the risk of sudden cardiac death. The complete protocol — including eligibility criteria and management pathway — is available via the full regimen.

Instant Access to Structured Evidence-Based Regimens

References

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.

DOI: 10.1093/eurheartj/ehad194

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