International Journal of Arrhythmia  2017;18(1):6-15

doi:10.18501/arrhythmia.2017.001

Design of Korean Noninvasive Risk Evaluation Study for Sudden Cardiac Death from Infarction or Heart Failure: Myocardial infarction study of K-REDEFINE registry.

Seung Jung PARK 1 ; Gyo Seung HWANG ; Gi Byoung NAM ; Hyung Wook PARK ; Joong Wha CHUNG ; Seung Yong SHIN ; Sang Min KIM ; Jun Hyung KIM ; Young Soo LEE ; Yae Min PARK ; Jong Youn KIM ; Dae Hyeok KIM ; Dae Kyeong KIM ; June NAMGUNG ; Dae Hee SHIN ; Joon Hyouk CHOI ; Hyoung Seob PARK ; Jong Il CHOI ; Jin Seok KIM ; Tae Joon CHA ; Sang Weon PARK ; Jae Sun UHM ; Nam Ho KIM ; Minsoo AHN ; Dong Gu SHIN ; Nuri JANG ; Meemo PARK ; June Soo KIM

Affiliations

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Keywords

Sudden Cardiac Death; Myocardial Infarction; Electrocardiography; Ambulatory

Country

Republic of Korea

Language

English

Abstract

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 turbulence/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.