It is generally accepted that the current guidelines for the primary prevention of sudden arrhythmic death, which are based on ejection fraction, do not allow the optimal selection of patients with low left ventricular ejection fraction of ischemic and nonischemic etiology for implantation of a cardioverter-defibrillator. Ejection fraction alone is limited in both sensitivity and specificity. A...

In 61 patients (77 studies) who had a transmural myocardial infarction, we compared the left ventricular ejection fraction by echocardiography with the ejection fraction determined by a computerized radioisotope technique that makes no assumptions regarding left ventricular geometry. In 31 studies of 26 patients with normal left ventricular wall motion by videotracking and normal left heart siz...