Who gets ICDs? New imaging could better ID patients in need

Implantable cardiac defibrillators can be lifesaving for patients with advanced heart disease, but it's not always easy to identify those most at risk of sudden cardiac arrest. Researchers at the University at Buffalo, however, may have found a new method for tagging that risk and getting the right devices into the right patients.

In findings presented Thursday, the researchers discovered that they can use PET scans to see where sympathetic nerves in the heart have been killed or damaged by inadequate blood flow, and that deterioration can predict sudden cardiac arrest. When at least 38% of the heart was denervated, the increased risk was significant, they reported.

This could be more effective than ejection fraction, the current method for identifying who get an ICD. That technique measures the percentage of blood the heart pumps with each beat, and patients who drop below 35% are generally ICD candidates. However, that's not a foolproof indicator, according to the scientists at the University of Buffalo.

"Since many patients who suffer a cardiac arrest do not have severely depressed heart function, PET imaging may be able to identify high-risk individuals who, in the future, could be considered candidates for an ICD," principal investigator John Canty said in a statement.

And more identified patients could mean a larger market for ICDs. That comes just in time, since St. Jude ($STJ) and Biotronik have recently announced FDA approvals for their next-gen devices, and Boston Scientific ($BSX) recently acquired ICD startup Cameron Health for about $150 million. 

- read the University at Buffalo's release