Int J Arrhythm.  2017 Mar;18(1):6-15. 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

• Park SJ
• Hwang GS
• Nam GB
• Park HW
• Chung JW
• Shin SY
• Kim SM
• Kim JH
• Lee YS
• Park YM
• Kim JY
• Kim DH
• Kim DK
• Namgung J
• Shin DH
• Choi JH
• Park HS
• Choi JI
• Kim JS
• Cha TJ
• Park SW
• Uhm JS
• Kim NH
• Ahn M
• Shin DG
• Jang N
• Park M
• Kim JS
• K-REDEFINE investigators

• KMID: 2377061
• DOI: http://doi.org/10.18501/arrhythmia.2017.001

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.

Keyword

Sudden Cardiac Death; Myocardial Infarction; Electrocardiography; Ambulatory

MeSH Terms

Arrhythmias, Cardiac
Death, Sudden, Cardiac*
Electrocardiography
Heart Failure*
Heart Rate
Heart*
Humans
Incidence
Infarction*
Myocardial Infarction*
Prospective Studies
Referral and Consultation
Registries
Risk Factors
Stroke
Stroke Volume