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Current Directions in Biomedical Engineering

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Buzug, Thorsten M. / Haueisen, Jens / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Kraft, Marc / Lenarz, Thomas / Leonhardt, Steffen / Malberg, Hagen / Penzel, Thomas / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Urban, Gerald A.


CiteScore 2018: 0.47

Source Normalized Impact per Paper (SNIP) 2018: 0.377

Open Access
Online
ISSN
2364-5504
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Biosignal-guided personalized therapy

An application for cardiac risk stratification

Lukas von Stülpnagel
  • Corresponding author
  • Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistr. 15, 81377 München, Germany
  • Heinz Nixdorf-Lehrstuhl für Medizinische Elektronik, Fakultät für Elektro- und Informationstechnik, Technische Universität München, Theresienstr. 90, 80339 München, Germany
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/ Bernhard Wolf
  • Fakultät für Elektro- und Informationstechnik, Technische Universität München, Theresienstr. 90, 80339 München, Germany
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/ Axel Bauer
  • Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistr. 15, 81377 München, Germany
  • DZHK (German Centre for Cardiovascular Research), partner site Munich, Munich, Germany
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Published Online: 2017-09-07 | DOI: https://doi.org/10.1515/cdbme-2017-0037

Abstract

Sudden cardiac death (SCD) is the leading single cause of death in the industrialized world. Current guidelines recommend a prophylactic implantation of an implantable cardioverter-defibrillator (ICD) in patients with reduced left-ventricular ejection fraction (LVEF ≤ 35%). However, most deaths after myocardial infarction (MI) occur in patients with normal or moderately reduced LVEF (>35%). There is a large body of evidence that cardiac autonomic dysfunction after MI is linked to increased susceptibility to malignant arrhythmias. Deceleration capacity of heart rate (DC) and periodic repolarization dynamics (PRD) are novel ECG-based risk markers, which capture different facets of cardiac autonomic dysfunction. Both parameters are strong and independent predictors of mortality and SCD after MI. Previous studies indicated that combined assessment of DC and PRD allows identification of a new high-risk group among post-infarction patients that is not addressed by current guidelines, thus opening new perspectives for biosignal-guided personalized therapies.

Keywords: sudden death; risk stratification; autonomic nervous system

About the article

Published Online: 2017-09-07


Citation Information: Current Directions in Biomedical Engineering, Volume 3, Issue 2, Pages 179–181, ISSN (Online) 2364-5504, DOI: https://doi.org/10.1515/cdbme-2017-0037.

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©2017 Lukas von Stülpnagel et al., published by De Gruyter. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License. BY-NC-ND 4.0

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