Sudden cardiac death (SCD) remains a leading cause of mortality among patients with cardiomyopathy, particularly those in the early stages of heart failure without significant ventricular dysfunction. This research topic seeks to explore innovative risk stratification approaches for primary prevention of SCD in these populations, encompassing both ischemic and non-ischemic cardiomyopathy patients. Through a combination of non-invasive and invasive diagnostic procedures, we aim to refine prognostic models that can guide personalized therapeutic interventions, including device therapy and intracardiac ablation.

We decided to explore this topic for the following reasons:

o Although we know that the SCD rate has significantly been reduced among modern societies based on good epidemiological data, it remains a significant life-threatening problem among those ischemic or non-CMP patients at early HF stages without significant LV dysfunction.
o Even non-published data with an AI-mostly imaging-related flavor (e.g., PROFID study) has disappointed us.
o It's very likely that a multifactorial non-invasive approach has to be supplemented by a thorough invasive Electrophysiology Study looking after not only tachyarrhythmic but also bradyarrhythmic evidence of risk.
o If such a 2-step EP-inclusive Risk Stratification Approach truly identifies the at-risk cardiac patient, then we should discuss the best therapeutic approach, namely device and/or ablation therapy even considering wearable devices.

Objectives:
1. Diagnostic Techniques for Early Detection of SCD Risk:
o Novel applications and comparative studies of non-invasive imaging modalities, including echocardiography, cardiac MRI, and CT scanning, in SCD risk assessment.
o Advances in genetic and biomarker evaluations specifically targeting early-stage cardiomyopathy.
o The role of non-invasive electrophysiological studies in arrhythmic risk prediction.
o Focusing on good scientific evidence diagnostic and therapeutic items with emphasis on non-invasive imaging and ECG findings, genetics, and important history data (e.g., unexplained syncope, family history of CMP with or without SCD, previous CV-related procedures).

2. Pathophysiological Insights in Ischemic and Non-Ischemic Cardiomyopathy:
o Exploration of the differing mechanisms of SCD in ischemic versus non-ischemic cardiomyopathy.
o Distinct risk factors and diagnostic markers pertinent to each subtype.

3. Innovative Risk Prediction Models:
o Development of comprehensive risk scores integrating clinical, imaging, genetic, and electrophysiological data.
o Utilization of machine learning and artificial intelligence to enhance accuracy in risk stratification.
o Inclusion of discussions on future perspectives in this field with not so well-studied topics such as wearables and virtual EP/MRI studies in the context of the much promising but also nascent field of Artificial Intelligence.

4. Therapeutic Strategies and Their Effectiveness:
o Examination of the success and challenges of device therapies, such as ICDs and CRT, for SCD prevention in this patient population.
o Evaluation of intracardial ablation techniques in managing arrhythmic substrates and reducing SCD risk.
o Long-term outcomes and quality-of-life assessments post-intervention.
o Discussion on supplementing non-invasive approaches with thorough invasive Electrophysiology Studies and their role in risk stratification and management.

We welcome all article types that contribute to the understanding and application of risk stratification and prevention strategies for SCD in early-stage cardiomyopathy patients. Contributions should focus on innovative diagnostic procedures, novel predictive models, and the efficacy of various therapeutic interventions.

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Frontiers in Cardiovascular Medicine

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