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KMID : 1011920170180010006
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International Journal of Arrhythmia
2017 Volume.18 No. 1 p.6 ~ p.15
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Design of Korean Noninvasive Risk Evaluation Study for Sudden Cardiac Death from Infarction or Heart Failure ? Myocardial infarction study of K-REDEFINE registry -
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Park Seung-Jung
Hwang Gyo-Seung
Nam Gi-Byoung
Park Hyung-Wook
Chung Joong-Wha
Shin Seung-Yong
Kim Sang-Min
Kim Jun-Hyung
Lee Young-Soo
Park Yae-Min
Kim Jong-Youn
Kim Dae-Hyeok
Kim Dae-Kyeong
Namgung June
Shin Dae-Hee
Choi Joon-Hyouk
Park Hyoung-Seob
Choi Jong-Il
Kim Jin-Seok
Cha Tae-Joon
Park Sang-Weon
Uhm Jae-Sun
Kim Nam-Ho
Ahn Min-Soo
Shin Dong-Gu
Jang Nu-Ri
Park Mee-Mo
Kim June-Soo
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Abstract
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Background and Objectives: Despite significant advances in the treatment of acute myocardial infarction (MI), the prevention of sudden cardiac death (SCD), the most common mode of death in patients with MI, remains challenging. Furthermore, previous Korean MI registries did not address the issue of post-MI SCD. Additional risk stratifiers of post-MI SCD are still required to compensate for the limitation of using left ventricular ejection fraction to predict lethal arrhythmic events.
Subjects and Methods: We designed the first Korean prospective nationwide multicenter registry primarily focused on SCD; the Korean noninvasive Risk Evaluation study for sudden cardiac DEath From INfarction or heart failurE (K-REDEFINE). The registry consists of 2 groups of patients presenting with (1) acute MI or (2) acute heart failure (HF) at 25 tertiary referral cardiovascular centers. The primary endpoint of the MI group study of K-REDEFINE registry is the incidence and risk factors of post-MI SCD. In particular, the association between the risk of SCD and non-invasive Holter-based electrocardiogram (ECG) variables will be evaluated, such as T-wave alternans (marker of repolarization heterogeneity) and heart rate tur-bulence/variability (a marker of autonomic function). Other secondary study outcomes include atrioventricular arrhythmias, HF-related admission, repeated myocardial ischemic events, stroke, and overall deaths.
Conclusion and Perspective: The K-REDEFINE registry will provide new prospects for the better management of MI patients with high risk of SCD by clarifying the burden and predictors of SCD and the clinical utility of various non-invasive ambulatory ECG-based variables in risk stratification for SCD in this patient population.
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KEYWORD
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Sudden Cardiac Death, Myocardial Infarction, Electrocardiography, Ambulatory
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