This latest video from Arrhythmia Academy's Journal Club examines the topic of myocardial fibrosis as a predictor of arrhythmic events, with consideration of scar and arrhythmia risk in two patient populations: coronary artery disease and in patients with a recent MI.

Prof Leyva (Birmingham, UK) presents the results from his latest publication in JACC with Zegard, Okafor, de Bono et al. on Myocardial Fibrosis as a Predictor of Sudden Death in Patients With Coronary Artery Disease. The results of which show a clear relationship between the presence or absence of scar and grey zone mass in patients with myocardial fibrosis, as an indication of the arrhythmic risk, which is superior to LVEF.

Dr Berruezo (Barcelona, ES) presents his recent study which considers the CMR determinants of VA events after MI. Results showed that reclassifying patients by BZ fibrosis mass with scar mass analysis is a better way of identifying both cases and controls, superior to LVEF.

The panel discuss if, based on these recent studies, an assessment of myocardial fibrosis would be preferable to LVEF in selecting patients for ICD therapy. Next steps and future challenges will also be discussed.

Dr Valentina Kutyfia (Rochester, NY, US) moderates this thought-provoking discussion.