Sacubitril/valsartan and the risk of sudden cardiac death
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1st Department of Cardiology Medical University of Warsaw
Department of Electrophysiology, Helios Clinic Koethen
Medical Faculty of University of Leipzig
Krzysztof Ozieranski   

1st Department of Cardiology Medical University of Warsaw, Banacha 1 a Street, 02-091 Warsaw, Poland
Publication date: 2018-11-16
Heart Beat 2018;3:59–60
Patients with heart failure (HF) with reduced left ventricle ejection fraction (HFrEF) are at high risk of sudden cardiac death (SCD). Therefore HFrEF treatment requires further improvement, what may be accomplished with use of sacubitril/valsartan. Sacubitril/valsartan reduce the risks of all-cause mortality, cardiovascular mortality, SCD, HF mortality, HF and all-cause hospitalizations, as well as symptoms of HF. It was also shown also that use of sacubitril/valsartan may be associated with reduced number of adequate and inadequate device interventions in HFrEF patients with implantable cardioverter defibrillator, and increased percentage of biventricular pacing in patients with cardiac resynchronization therapy. Sacubitril/valsartan blocks the angiotensin II receptor (valsartan) and inhibits neprilysin (sacubitril) simultaneously. It results in inhibited sympathetic activity, as well as decreased cardiac remodeling and fibrosis, resulting in decreased pro-arrhythmogenic effect.