Cited by 356Cardiac electrophysiology and arrhythmiasCardiac pacing and defibrillation studiesCardiac Health and Mental Health

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Limitations of Ejection Fraction for Prediction of Sudden Death Risk in Patients With Coronary Artery Disease

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Buxton, Alfred E., Lee, Kerry L., Hafley, Gail E., Pires, Luis A., Fisher, John D., Gold, Michael R., Josephson, Mark E., Lehmann, Michael H., Prystowsky, Eric N.·2007·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2007.04.095

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Abstract

Objectives We determined the contribution of multiple variables to predict arrhythmic death and total mortality risk in patients with coronary disease and left ventricular dysfunction. We then constructed an algorithm to predict risk of mortality and sudden death.Background Many factors in addition to ejection fraction (EF) influence the prognosis of patients with coronary disease. However, there are few tools to use this information to guide clinical decisions.Methods We evaluated the relationship between 25 variables and total mortality and arrhythmic death in 674 patients enrolled in the MUSTT (Multicenter Unsustained Tachycardia Trial) study that did not receive antiarrhythmic therapy. We then constructed risk-stratification algorithms to weight the prognostic impact of each variable on arrhythmic death and total mortality risk.Results The variables having the greatest prognostic impact in multivariable analysis were functional class, history of heart failure, nonsustained ventricular tachycardia not related to bypass surgery, EF, age, left ventricular conduction abnormalities, inducible sustained ventricular tachycardia, enrollment as an inpatient, and atrial fibrillation. The model demonstrates that patients whose only risk factor is EF < or =30% have a predicted 2-year arrhythmic death risk <5%.Conclusions Multiple variables influence arrhythmic death and total mortality risk. Patients with EF < or =30% but no other risk factor have low predicted mortality risk. Patients with EF >30% and other risk factors may have higher mortality and a higher risk of sudden death than some patients with EF < or =30%. Thus, risk of sudden death in patients with coronary disease depends on multiple variables in addition to EF.

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Self-citation
Signal‐averaged electrocardiography: Past, present, and future
Gatzoulis, K. A., Αρσένος, Π., Trachanas, K., Dilaveris, P., Antoniou, C. K., Tsiachris, D., Sideris, S. K., Kolettis, T. M., & Tousoulis, D. M. (2018) · Journal of Arrhythmia · doi:10.1002/joa3.12062 · Cited by 65
“This development increases the need for more accurate identification of potential candidates for ICD therapy and supports emerging views, challenging the current use of LVEF as the main variable in primary SCD prevention.(23) Specifically, LVEF is subject to operator biases and depends on loading conditions and heart…”
Background
Characteristics and Outcomes of Patients Receiving New and Replacement Implantable Cardioverter-Defibrillators
Kramer, D. B., Kennedy, K. F., Noseworthy, P. A., Buxton, A. E., Josephson, M. E., Normand, S. T., Spertus, J. A., ZIMETBAUM, P. J., Reynolds, M. R., & Mitchell, S. L. (2013) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.111.000054 · Cited by 64
“For this report, variables were selected a priori from the ICD Registry that were felt to be necessary to describe and examine the characteristics and outcomes of patients receiving replacement ICD devices based on American College of Cardiology/American Heart Association guidelines for device-based therapy(5) as well…”
MethodSelf-citation
Prediction of Sudden Cardiac Death Manifesting With Documented Ventricular Fibrillation or Pulseless Ventricular Tachycardia
Chugh, S. S., Reinier, K., Uy‐Evanado, A., Chugh, H. S., Elashoff, D. A., Young, C., Salvucci, A., & Jui, J. (2022) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2022.02.004 · Cited by 63
Incidence of Appropriate Shock in Implantable Cardioverter-Defibrillator Patients With Improved Ejection Fraction
Naksuk, N., Saab, A., Li, J.-M., Florea, V. G., Akkaya, M., Anand, I. S., Benditt, D. G., & Adabağ, S. (2013) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2013.04.007 · Cited by 61
Risk stratification for sudden death in patients with coronary artery disease
Buxton, A. E. (2009) · Heart Rhythm · doi:10.1016/j.hrthm.2009.02.016 · Cited by 58
Self-citation
Single-Photon Emission Computed Tomography Myocardial Perfusion Defects Are Associated With an Increased Risk of All-Cause Death, Cardiovascular Death, and Sudden Cardiac Death
Piccini, J. P., Horton, J. R., Shaw, L. K., Al‐Khatib, S. M., Lee, K. L., Iskandrian, A. E., & Borges‐Neto, S. (2008) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.108.776484 · Cited by 59
Self-citation
Predictors of sudden cardiac death change with time after myocardial infarction: results from the VALIANT trial
Piccini, J. P., Zhang, M., Pieper, K. S., Solomon, S. D., Al‐Khatib, S. M., de Werf, F. V., Pfeffer, M. A., McMurray, J. J. V., Califf, R. M., & Velazquez, E. J. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp425 · Cited by 57
Myocardial scar characteristics based on cardiac magnetic resonance imaging is associated with ventricular tachyarrhythmia in patients with ischemic cardiomyopathy
Demirel, F., Adiyaman, A., Timmer, J. R., Dambrink, J. E., Kok, M., Boeve, W. J., & Elvan, A. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.08.132 · Cited by 56
“Therefore, the use of LVEF as an indicator for ICD implantation is far from ideal [2,6,7].”
Background
Risk Stratification for Sudden Cardiac Death After Myocardial Infarction
Waks, J. W., & Buxton, A. E. (2018) · Annual Review of Medicine · doi:10.1146/annurev-med-041316-090046 · Cited by 58
Self-citation
Prediction of sudden arrhythmic death following acute myocardial infarction
Liew, R. (2010) · Heart · doi:10.1136/hrt.2010.194407 · Cited by 54
“However, it is becoming increasingly apparent that additional variables other than reduced LVEF may influence the risk of sudden cardiac death and that LVEF alone is insufficient in determining which patients are most likely to benefit from prophylactic ICD insertion.(5) Indeed, the majority of sudden deaths occur in…”
Background
Prediction of ventricular arrhythmias using cardiovascular magnetic resonance
Mavrogeni, S. I., Petrou, E., Kolovou, G., THEODORAKIS, G. N., & Iliodromitis, E. K. (2013) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jes302 · Cited by 54
Protein Biomarkers Identify Patients Unlikely to Benefit From Primary Prevention Implantable Cardioverter Defibrillators
Cheng, A., Zhang, Y., Blasco‐Colmenares, E., Dalal, D., Butcher, B., Norgard, S., ELDADAH, Z. A., Ellenbogen, K. A., Dickfeld, T. M., SPRAGG, D. D., et al. (2014) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.001705 · Cited by 56
“The limited sensitivity and specificity of using the ejection fraction as the primary means for SCD risk stratification has resulted in many individuals receiving ICDs deriving little benefit and also failing to identify individuals with relatively preserved function but remain at high SCD risk.(27) In fact, the Table…”
Background
A Novel ECG-Index for Prediction of Ventricular Arrhythmias in Patients after Myocardial Infarction
Hetland, M., Haugaa, K. H., Sarvari, S. I., Erikssen, G., Kongsgaard, E., & Edvardsen, T. (2014) · Annals of Noninvasive Electrocardiology · doi:10.1111/anec.12152 · Cited by 53
Radionuclide imaging of cardiac autonomic innervation
Ji, S. Y., & Travin, M. I. (2010) · Journal of Nuclear Cardiology · doi:10.1007/s12350-010-9239-x · Cited by 52
Usefulness of the QRS-T Angle to Improve Long-Term Risk Stratification of Patients With Acute Myocardial Infarction and Depressed Left Ventricular Ejection Fraction
Raposeiras‐Roubín, S., Virgós-Lamela, A., Bouzas‐Cruz, N., López-López, A., Castiñeira-Busto, M., Garda, R. F., García‐Castelo, A., Rodríguez‐Mañero, M., García‐Acuña, J. M., Abu-Assi, E., et al. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.01.406 · Cited by 52
“Because the left ventricular ejection fraction (LVEF) is neither highly specific nor highly sensitive as a risk factor for follow-up death, considerable interest exists in identifying novel risk factors that may be more useful than, or adjunctive to, those currently employed.(4,5) Data from rest electrocardiography ma…”
Background
Competing risk and heterogeneity of treatment effect in clinical trials
Kent, D. M., Alsheikh-Ali, A. A. A., & Hayward, R. A. (2008) · Trials · doi:10.1186/1745-6215-9-30 · Cited by 52
“However, the criteria used to identify eligible patients at high risk for sudden cardiac death (SCD), namely a left ventricular ejection fraction of 35% or less, also identifies patients at risk of cardiac death from pump failure [26,27].”
BEtablocker Treatment After acute Myocardial Infarction in revascularized patients without reduced left ventricular ejection fraction (BETAMI): Rationale and design of a prospective, randomized, open, blinded end point study
Munkhaugen, J., Ruddox, V. D. B., Halvorsen, S., Dammen, T., Fagerland, M. W., Hernæs, K. H., Vethe, N. T., Prescott, E., Jensen, S. E., Rødevand, O., et al. (2018) · American Heart Journal · doi:10.1016/j.ahj.2018.10.005 · Cited by 51
Mortality risk following replacement implantable cardioverter-defibrillator implantation at end of battery life: Results from the NCDR®
Kramer, D. B., Kennedy, K. F., Spertus, J. A., Normand, S. T., Noseworthy, P. A., Buxton, A. E., Josephson, M. E., ZIMETBAUM, P. J., Mitchell, S. L., & Reynolds, M. R. (2013) · Heart Rhythm · doi:10.1016/j.hrthm.2013.10.046 · Cited by 51
Self-citation
Impact of Chronic Total Occlusions and Coronary Revascularization on All-Cause Mortality and the Incidence of Ventricular Arrhythmias in Patients With Ischemic Cardiomyopathy
Raja, V. N., Wiegn, P., OBEL, O. A., Christakopoulos, G. E., Christopoulos, G., Rangan, B. V., Roesle, M. K., Abdullah, S. M., Luna, M., Addo, T. A., et al. (2015) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2015.07.057 · Cited by 51
Left atrial booster pump function is an independent predictor of subsequent life-threatening ventricular arrhythmias in non-ischaemic cardiomyopathy
Negishi, K., Negishi, T., Zardkoohi, O., Ching, E. A., Basu, N., Wilkoff, B. L., Popović, Z., & Marwick, T. H. (2015) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jev333 · Cited by 48
The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects
Narayanan, K., & Chugh, S. S. (2015) · EP Europace · doi:10.1093/europace/euv121 · Cited by 48
A new electrocardiogram marker to identify patients at low risk for ventricular tachyarrhythmias: sum magnitude of the absolute QRST integral
Tereshchenko, L. G., Cheng, A., Fetics, B. J., Butcher, B., Marine, J. E., SPRAGG, D. D., Sinha, S. K., Dalal, D., Calkins, H. G., Tomaselli, G. F., et al. (2010) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2010.08.012 · Cited by 46
“The need to extend risk stratification beyond use of ejection fraction (EF) is well recognized.(5,6) A U-shaped curve for ICD benefit was shown in the analysis of the Multicenter Automatic Defibrillator Implantation Trial II,(5) prompting a search for markers that identify low-risk patients who do not benefit from ICD…”
Implantable cardioverter defibrillator therapy activation for high risk patients with relatively well preserved left ventricular ejection fraction. Does it really work?
Gatzoulis, K. A., Tsiachris, D., Dilaveris, P., Archontakis, S., Αρσένος, Π., Vouliotis, A., Sideris, S. K., Trantalis, G., Kartsagoulis, E., Kallikazaros, I. E., et al. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.04.005 · Cited by 45
“This approach is in line with retrospective analyses of MUSTT, where inducible VT/VF but not low LVEF could discriminate between modes of death, identifying patients at increased arrhythmic death, especially if LVEF was ≥30% [13,14].”
Result
T‐Wave Morphology Restitution Predicts Sudden Cardiac Death in Patients With Chronic Heart Failure
Ramírez, J., Orini, M., Mincholé, A., Monasterio, V., Cygankiewicz, I., de Luna, A. B., Martínez, J. P., Pueyo, E., & Laguna, P. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.116.005310 · Cited by 44
“Most of those markers are also associated with PFD and have a reduced specificity for SCD risk prediction.(22,25,26) In our study, we demonstrate that TMR is a specific marker of SCD with no relation to PFD risk (Figure 3A).”
Ventricular Arrhythmias
Almahameed, S., & Ziv, O. (2019) · Medical Clinics of North America · doi:10.1016/j.mcna.2019.05.008 · Cited by 44
The need to modify patient selection to improve the benefits of implantable cardioverter-defibrillator for primary prevention of sudden death in non-ischaemic dilated cardiomyopathy
Disertori, M., Quintarelli, S., Mazzola, S., Favalli, V., Narula, N., & Arbustini, E. (2013) · EP Europace · doi:10.1093/europace/eut228 · Cited by 44
The utility of ADMIRE-HF risk score in predicting serious arrhythmic events in heart failure patients: Incremental prognostic benefit of cardiac 123I-mIBG scintigraphy
Badarin, F. J. A., Wimmer, A. P., Kennedy, K. F., Jacobson, A. F., & Bateman, T. M. (2014) · Journal of Nuclear Cardiology · doi:10.1007/s12350-014-9919-z · Cited by 44
Denervated Myocardium Is Preferentially Associated With Sudden Cardiac Arrest in Ischemic Cardiomyopathy
Fallavollita, J. A., Dare, J. D., Carter, R. L., Baldwa, S., & Canty, J. M. (2017) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.117.006446 · Cited by 44
Prognostic significance of ambulatory ECG monitoring for ventricular arrhythmias
Katritsis, D. G., Siontis, G. C. M., & Camm, A. J. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2013.07.005 · Cited by 44
Risk Factor and Prediction Modeling for Sudden Cardiac Death in Women with Coronary Artery Disease
Deo, R., Vittinghoff, E., Lin, F., Tseng, Z. H., Hulley, S., & Shlipak, M. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.328 · Cited by 44
“These findings complement those of prior studies in higher-risk populations that suggest that there is an improvement in SCD risk prediction when clinical risk factors are combined with ejection fraction.(27,28) Our final model, which consisted of both LVEF and clinical risk factors, also differentiated between SCD an…”
Implantable Cardioverter-Defibrillators at End of Battery Life
Merchant, F. M., Quest, T. E., León, A. R., & El‐Chami, M. F. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.11.033 · Cited by 44
A Simple Community-Based Risk-Prediction Score for Sudden Cardiac Death
Bogle, B. M., Ning, H., Goldberger, J. J., Mehrotra, S., & Lloyd‐Jones, D. M. (2017) · The American Journal of Medicine · doi:10.1016/j.amjmed.2017.12.002 · Cited by 44
The role of the immuno-inflammatory response in patients after cardiac arrest
Samborska-Sablik, A., Sablik, Z., & Gaszyński, W. (2011) · Archives of Medical Science · doi:10.5114/aoms.2011.24131 · Cited by 41
Current Clinical Applications and Next Steps for Cardiac Innervation Imaging
Travin, M. I. (2017) · Current Cardiology Reports · doi:10.1007/s11886-017-0817-2 · Cited by 41
Benefits of the Implantable Cardioverter-Defibrillator
Epstein, A. E. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.06.035 · Cited by 40
Right ventricular function assessed by 2D strain analysis predicts ventricular arrhythmias and sudden cardiac death in patients after acute myocardial infarction
Risum, N., Valeur, N., Søgaard, P., Hassager, C., Køber, L., & Ersbøll, M. K. (2017) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jex184 · Cited by 39
“Left ventricular (LV) dysfunction [ejection fraction (EF) < 35%] is the most established parameter for selection of ICD patients(2) but has demonstrated limited ability in prediction of outcomes.(3) Thus, the current selection criteria for ICD needs to be further refined.”
Background
Detection of sudden cardiac death by a comparative study of heart rate variability in normal and abnormal heart conditions
Rohila, A., & Sharma, A. (2020) · Journal of Applied Biomedicine · doi:10.1016/j.bbe.2020.06.003 · Cited by 44
Myocardial Fibrosis as a Pathway of Prediction of Ventricular Arrhythmias and Sudden Cardiac Death in Patients With Nonischemic Dilated Cardiomyopathy
Centurión, O. A., Alderete, J. F., Torales, J. M., García, L. B., Scavenius, K. E., & Miño, L. M. (2019) · Critical Pathways in Cardiology A Journal of Evidence-Based Medicine · doi:10.1097/hpc.0000000000000171 · Cited by 37
Noninvasive Risk Stratification for Sudden Death: Signal-Averaged Electrocardiography, Nonsustained Ventricular Tachycardia, Heart Rate Variability, Baroreflex Sensitivity, and QRS Duration
Steín, K. M. (2008) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2007.10.001 · Cited by 37
“The absence of any “dose effect” to NSVT in MUSTT is concerning— patients with long runs of NSVT had the same outcome as those with only short episodes.(68) It is likewise intriguing to note that the absolute mortality reduction in DEFINITE was quite similar to the mortality reduction in observed in the nonischemic ca…”
Result
Recommendations for the use of electrophysiological study: Update 2018
Mureşan, L., Cismaru, G. L., Martins, R. P., Bataglia, A., Roşu, R., Puiu, M., Guşetu, G., Mada, R. O., Muresan, C., Ispas, D. R., et al. (2018) · Hellenic Journal of Cardiology · doi:10.1016/j.hjc.2018.09.002 · Cited by 37
Current Evidence Base for Use of the Implantable Cardioverter–Defibrillator
Hohnloser, S. H., & Israel, C. W. (2013) · Circulation · doi:10.1161/circulationaha.112.000547 · Cited by 34
Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction
Lerma, C., Gorelick, A. N., Ghanem, R. N., Glass, L., & Huikuri, H. V. (2013) · EP Europace · doi:10.1093/europace/eus415 · Cited by 34
“LVEF , 40%, non-sustained VT on Holter recording, and the inducibility of sustained VT during the electrophysiological study.(10) This study complies with the Declaration of Helsinki, locally appointed ethics committees approved the research protocol and informed consent was obtained from the patients.”
Method
Use of cardiac radionuclide imaging to identify patients at risk for arrhythmic sudden cardiac death
Kelesidis, I., & Travin, M. I. (2011) · Journal of Nuclear Cardiology · doi:10.1007/s12350-011-9482-9 · Cited by 32
Effect of Age on Survival and Causes of Death After Primary Prevention Implantable Cardioverter-Defibrillator Implantation
Fauchier, L., Marijon, É., Defaye, P., Piot, O., Sadoul, N., Perier, M., Gras, D., Klug, D., Algalarrondo, V., Bordachar, P., et al. (2015) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2015.02.031 · Cited by 32
Risk Stratification of Sudden Cardiac Death After Acute Myocardial Infarction
Bui, A. H., & Waks, J. W. (2018) · Journal of Innovations in Cardiac Rhythm Management · doi:10.19102/icrm.2018.090201 · Cited by 36
Effect of SAcubitril/Valsartan on left vEntricular ejection fraction and on the potential indication for Implantable Cardioverter Defibrillator in primary prevention: the SAVE-ICD study
Guerra, F., Ammendola, E., Ziacchi, M., Aspromonte, V., Pellegrino, P. L., Giorno, G. D., Dell’Era, G., Pimpini, L., Santoro, F., Floris, R., et al. (2021) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-021-03189-8 · Cited by 32
Sudden Cardiac Death in Patients With Silent Myocardial Ischemia After Myocardial Infarction (from the Swiss Interventional Study on Silent Ischemia Type II [SWISSI II])
Schoenenberger, A. W., Kobza, R., Jamshidi, P., Züber, M., Abbate, A., Stuck, A. E., Pfisterer, M. E., & Erné, P. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.03.019 · Cited by 31
Resting perfusion MPI-SPECT combined with cardiac 123I-mIBG sympathetic innervation imaging improves prediction of arrhythmic events in non-ischemic cardiomyopathy patients: Sub-study from the ADMIRE-HF trial
Sood, N. A., Badarin, F. J. A., Parker, M. W., Pullatt, R. C., Jacobson, A. F., Bateman, T. M., & Heller, G. V. (2013) · Journal of Nuclear Cardiology · doi:10.1007/s12350-013-9750-y · Cited by 31

Authors: Buxton, A. E., Lee, K. L., Hafley, G. E., Pires, L. A., Fisher, J. D., Gold, M. R., Josephson, M. E., Lehmann, M. H., & Prystowsky, E. N.
Affiliations: Brown University (US)
Duke Medical Center (US)
Albert Einstein College of Medicine (US)
Medical University of South Carolina (US)
Beth Israel Deaconess Medical Center (US)
University of Michigan (US)
Corresponding author: Buxton, Alfred E.
ORCID: Buxton, Alfred E.
Lee, Kerry L.
Fisher, John D.
Gold, Michael R.
Lehmann, Michael H.
Prystowsky, Eric N.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2007-09
Volume: 50
Issue: 12
Pages: 1150-1157
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2007.04.095
OpenAlex: W29926391
Cited by: 356
References: 25
Citations by year: 2026: 7 · 2025: 2 · 2024: 4 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 11 · 2019: 16 · 2018: 24 · 2017: 27 · 2016: 24 · 2015: 28 · 2014: 23 · 2013: 40 · 2012: 21
FWCI: 17.79
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2145 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5u01hl045726-06)
National Heart, Lung, and Blood Institute (UO1HL45700, UO1-HL45726, HL45700, U01HL045700)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: ejection fraction, sudden cardiac death, arrhythmic death, coronary artery disease, left ventricular dysfunction, risk stratification, mortality prediction, non-sustained ventricular tachycardia, atrial fibrillation, heart failure
MeSH terms: Aged, Anti-Arrhythmia Agents, Cause of Death, Coronary Artery Disease, Female, Heart Arrest, Humans, Male, Middle Aged, Predictive Value of Tests, Probability, Sensitivity and Specificity, Stroke Volume, Confidence Intervals, Chi-Square Distribution, Proportional Hazards Models, Death, Sudden, Cardiac, Defibrillators, Implantable, Tachycardia, Ventricular, Risk Assessment

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Limitations of Ejection Fraction for Prediction of Sudden Death Risk in Patients With Coronary Artery Disease

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