Severe Ventricular ctopy in Heart Failure Patients ew Marker for Aggregate Risk

n our current era marked with the beneficial addition of mplantable cardiac defibrillators (ICDs) and betadrenergic receptor blockade to our therapeutic strategies, it s increasingly difficult to identify the individual with dvanced systolic heart failure (HF) at high mortality risk 1). Traditionally, the peak maximum oxygen consumption dentified during symptom-limited, metabolic exercise readmill testing has been considered one of the best criteria s originally identified by Mancini et al. (2). However, in he current era of beta-blocker treatment for advanced HF, here are developing concerns regarding the interpretation f this marker in identifying the high-risk individual. For xample, Shaker et al. (3), in a retrospective analysis, emonstrated that the traditional peak oxygen-consumption ut-off value of 14 ml/kg/min does not predict survival free f cardiac transplant in patients who tolerate chronic treatent with beta-adrenergic receptor blockers. Therefore, it is oth important and relevant to identify new clinical markers f aggregate risk to assist in this decision-making process.