The term originates from the field of predicting the probability of future arrhythmias that could cause Arrhythmic Sudden Cardiac Death (SCD). It refers to the application of appropriate methodology to identify, among intermediate-risk patients, the specific subpopulation at truly high risk, ensuring they receive proper protection through the implantation of an Implantable Cardioverter-Defibrillator (ICD).

Risk stratification personalizes the likelihood of future risk, while its methodology varies depending on the type of cardiomyopathy of the affected patient. Considering all relevant data from a patient’s history, as well as the type and extent of myocardial substrate abnormalities, the 12-lead resting electrocardiogram, the presence of Late Potentials on SAECG, continuous 24-hour Holter monitoring, cardiac functional assessment by echocardiography, MRI imaging studies, and the inducibility of ventricular tachyarrhythmias during programmed ventricular stimulation in an electrophysiological study, it is possible to identify post-infarction ischemic patients at increased risk of SCD and protect them through the implantation of an Implantable Cardioverter-Defibrillator (ICD). In hypertrophic cardiomyopathy, dilated cardiomyopathy, and channelopathies, the methodology may vary and include the use of specific prognostic scores or targeted genetic testing.

In a similar manner, exploiting an active exploratory assessment approach of multiple data points, an individualized strategy can be applied to patients exhibiting predisposing risk factors for the early detection and management of subclinical Coronary Artery Disease (CAD), Atrial Fibrillation (AF), and Arterial Hypertension (AH).