Early Prediction of ICD Candidacy After Anterior Myocardial Infarction

Despite the advances of pharmacologic and interventional therapies, sudden (or arrhythmic) cardiac death remains very high in the early weeks-to-months after an acute myocardial infarction (MI).The majority of cardiac arrests occur in patients who have large infarctions resulting in extensive myocardial damage, which is translated into lower left ventricular ejection fraction (LVEF). Hence, low LVEF remains -to the current time- the most robust predictor for post MI sudden (and presumably arrhythmic) death; and is the determinant for implantable cardioverter defibrillator (ICD) candidacy for primary prevention as per clinical practice guidelines.ICD significantly and effectively reduced ventricular arrhythmia (VA)-mediated cardiac deaths among these patients.

Inclusion Criteria: * Age between 18 and 80 years. Both genders are eligible. * Patients with diagnosis of an acute anterior STEMI and revascularized with successful primary percutaneous coronary intervention (PCI) within 24 hours. * LVEF \< 40 % assessed by Bi-plane Simpsons rule within 48 hour post PCI. Exclusion Criteria: * ● Refusal to participate in the study. * Patients with existing ICD or pacemakers. * Qualifying ICD for secondary prevention. * Known to have LVEF ≤ 40% prior to the index MI. * Previous PCI to Left anterior Descending artery (LAD). * Previous or being scheduled for CABG within ≤ 3 months. * Known to have limited life expectancy (less than 1-year) prior to the index MI. * Pregnant or lactating women.