This study aims to assess ECG changes for predicting ventricular arrhythmia in cardiomyopathic patients

This study aims to assess ECG markers based on 24-hour Holter ECG recordings for predicting ventricular arrhythmia in patients with Structural Heart disease who have left ventricular dysfunction and Left Ventricular Ejection Fraction ≤40%. With special concerns to underlying structural abnormalities in cardiomyopathic patients using Cardiac Magnetic Resonance to determine ventricular function, scar distribution, and grey zone analysis

Inclusion Criteria:

• Patients with ischemic and non-ischemic cardiomyopathy, EF < 40 %
• Patient haemodynamically stable
• Patients accept to make test

Exclusion Criteria:

1. Patients with underlying arrhythmia ex heart block or atrial arrhythmia like PACs, AF.
2. Patients on arrhythmogenic drugs ex digitalis, amiodarone.
3. Patients on underlying Pacemaker device or CRT-D.
4. Patients with MI in less than 40 days
5. Patients refuse to make test .

The study is anticipated to include all consecutive eligible cardiomyopathic patients.