The Lead Episode 171: A Discussion of the CMR Guide Trial

Description:

In this episode of The Lead, host Jason T. Jacobson, MD, FHRS, is joined by Sei Iwai, MD, FHRS, and Jeanne E. Poole, MD, FHRS, CCDS, to discuss "Cardiovascular Magnetic Resonance to Guide Defibrillator Implantation for LVEF of 36% to 50%: The CMR GUIDE Randomized Clinical Trial." The panel examines the trial's findings on using cardiovascular magnetic resonance–identified myocardial scar to guide primary prevention ICD implantation, including limitations of the study and current approaches to sudden cardiac death risk stratification, as well as the potential role of more sophisticated, dynamic risk-prediction models.

Learning Objectives:

1. Describe the design, patient population, primary outcome, and key findings of the CMR GUIDE randomized clinical trial.

2. Evaluate the limitations of using cardiovascular magnetic resonance–identified myocardial scar to guide primary prevention ICD implantation in patients with an LVEF of 36% to 50%.

3. Assess current challenges and emerging approaches to sudden cardiac death risk stratification, including the potential use of multimodal and dynamic risk-prediction models.

Host: Jason T. Jacobson, MD, FHRS

Guests: Sei Iwai, MD, FHRS and Jeanne E. Poole, MD, FHRS, CCDS

Faculty Disclosures:

J. Jacobson

• Honoraria/Speaking/Consulting Fee: Zoll Medical Corporation, Vektor Medical, Inc., CardioFocus, Inc., Abbott Medical, Johnson and Johnson

• Stock Options-Privately Held: Atlas 5D

S. Iwai

• Honoraria/Speaking/Consulting Fee: Alta Thera Pharmaceuticals, Biotronik, Johnson and Johnson, CardioFocus, Inc.

J. Poole

• Honoraria/Speaking/Consulting Fee: Heart Rhythm Society

• Research (Contracted Grants): Boston Scientific, AtriCure, Inc., Kestra, Inc., Biotronik