Task Force on Sudden Cardiac Death, European Society of Cardiology (original) (raw)

Task Force on Sudden Cardiac Death of the European Society of Cardiology

European Heart Journal, 2001

This comprehensive, educational document on sudden cardiac death is an extensive review that was deemed necessary for two reasons: first, major studies have advanced our knowledge of the natural history, risk prediction and evaluation, and prevention of tachyarrhythmias and sudden death in patients with coronary artery disease or heart failure; second, in rare or previously unknown diseases, the recognition of high risk patients is more difficult since studies are either lacking or they are less likely to be performed.

The Prevention of Sudden Death: New Perspectives

Current News in Cardiology, 2007

Sudden cardiac death (SCD) is unexpected natural death due to cardiac causes, and includes the abrupt loss of consciousness within 1 h from the onset of acute symptoms, with or without preexisting heart disease. It is very difficult to evaluate the exact incidence of SCD because the concept of "sudden events" has not been precisely defined [1]. Estimates for the US show a mean incidence of 300,000 SCDs per year, 0.1-0.2% of the entire population [1]. In Italy, the number of events per year is around 50,000 (about 1/1,000 subjects/year) [2]. These estimates are related to the whole population, thus including SCDs as a primary cardiac event in healthy subjects and those occurring in high-risk patients. Despite the high number of events per year in the population, the percentage remains very low although it has increased progressively in high-risk subgroups. For example, in post-myocardial infarction (MI) patients and in subjects with prior malignant ventricular tachyarrhythmias the incidence of SCD is 35% [1]. In a Framingham Study re-analysis, risk factors for coronary artery disease were shown to be statistically related to SCD. The incidence in patients with several risk factors is 60 times higher than in those with only one [3]. Therefore, considering that the 80% of SCD is due to ischemic events, primary and secondary coronary artery disease prevention is of major importance. According to international guidelines and evidence-based medicine, the control of risk factors and of pharmacological treatment is very important.

Sudden cardiac death: epidemiology and risk factors

Nature reviews. Cardiology, 2010

Sudden cardiac death (SCD) is an important public-health problem with multiple etiologies, risk factors, and changing temporal trends. Substantial progress has been made over the past few decades in identifying markers that confer increased SCD risk at the population level. However, the quest for predicting the high-risk individual who could be a candidate for an implantable cardioverter-defibrillator, or other therapy, continues. In this article, we review the incidence, temporal trends, and triggers of SCD, and its demographic, clinical, and genetic risk factors. We also discuss the available evidence supporting the use of public-access defibrillators.

Sudden cardiac death: epidemiology, pathogenesis and management

Reviews in Cardiovascular Medicine

Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and the role of new technologies in the field. Further, we delineate the current epidemiologic trends and pathogenesis. In particular, we describe the advancement in molecular autopsy and genetic testing, the role of target temperature management, extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), and transvenous and subcutaneous implantable cardioverter devices (ICDs).

Sudden cardiac death: Prevalence, pathogenesis, and prevention

Annals of Medicine, 2008

Sudden cardiac death (SCD), also known as sudden arrest, is a major health problem worldwide. It is usually defined as an unexpected death from a cardiac cause occurring within a short time in a person with or without preexisting heart disease. The pathogenesis of SCD is complex and multifaceted. A dynamic triggering factor usually interacts with an underlying heart disease, either genetically determined or acquired, and the final outcome is the development of lethal tachyarrhythmias or, less frequently, bradycardia. It has increasingly been highlighted that a reliable clinical and diagnostic approach might be effective to unmask the most important genetic and environmental factors, allowing the construction of a rational personalized medicine framework that can be applied in both the preclinical and clinical settings of SCD. The aim of the present article is to provide a concise overview of prevalence, pathogenesis, clinical presentation, and diagnostic approach to this challenging disorder.

Contemporary Approaches in Prevention of Sudden Cardiac Death

2020

Sudden cardiac arrest and sudden cardiac death (SCD) are terms that are often used in medicine as synonyms. Sudden cardiac death is defined as "natural, unexpected cardiac death that occurs within one hour of the onset of acute symptoms and is accompanied by a sudden loss of consciousness." The presence of heart disease may be known from before, but the timing and manner of death are unexpected. Coronary artery disease (CAD) is responsible for 75-80% of all SCD. While atherosclerosis is a primary disease in middle-aged and elderly people, in children and young adults (<3 5 years), malignant arrhythmias that occur in the cardiac ventricles monomorphic or polymorphic ventricular tachycardia, and ventricular fibrillation are the most common cause of SCD. The etiology of heart rhythm disorders may be associated with underlying heart disease, but it is most commonly idiopathic in young people. A number of studies have confirmed that malignant arrhythmias are the immediate ca...

EC CARDIOLOGY Sudden Cardiac Death: Some Considerations On the Matter

Heart disease remains the leading cause of death worldwide. The Sudden cardiac death (or better the Unexpected Cardiac Death) can appear at any time and anywhere. Despite being the most wrenching event that any physician can find, (when it occurs in childhood the tragedy is supreme), the called " sudden cardiac death " is still quite unknown in its most intimate mechanisms of production. Delays in diagnosis, a big lack of previous diagnosis in many cases, as well as the immense discrepancies and controversies among the various authors, are the keys for such lack of knowledge. Lately, the implementation of semiautomatic defibrillators on the streets, supermarkets and the education of non-specialists people, is a quite effective method for the recovery and survival of people who have suffered such a wrenching event. Problem? Not work if do not capture heartbeat. Some deep and well documented studies are making possible the creation of some " risk score " for suffer an " unexpected cardiac death. " This can be very beneficial to its prevention, through an advice and pertinent medical interventions. (Thompson and Mc-Cullough score. Rajat and Faye score: Appurtenances 1 and 2). Unfortunately – at this time-, only around the 15% of people who have suffered this type of event is recovered. And of this 15% of people recovered, more than 85% will suffer some sort of neurological disorder for all life. Most sudden deaths occur outside the hospital, on the street. This considerably reduces the total recovery process. Also unfortunately, the discrepancies about the concept and management of such infamous situation are still very bountiful among medical professionals. The discrepancies about how it must be defined, what actions are necessary immediately to its apparition, and many other issues more, remain overwhelming. Here we will discuss some nuances about them. By way of example, the meaning of " sudden " does not mean " unexpected " necessarily. For Framingham Heart Study, sudden cardiac death is defined as: " death because of CHD occurring within 1 hour of symptom onset and not likely attributable to other causes ". We put 'called into question' this definition. We could say: " All the unexpected is sudden. Not all the sudden is unexpected ". We think this event should be called as: Unexpected cardiac death. As for the overall management of such an event, there are also many differences and controversies among the different authors. This subject also will be discussed in the document.

Fighting against sudden death: A single or multidisciplinary approach

Journal of Interventional Cardiac Electrophysiology, 2006

There are many causes of sudden death ranging from accidents and suicide to vascular events and arrhythmias. Most sudden deaths will occur in people who have not been diagnosed with a serious heart condition but at a very low annual rate. Many of these events are probably vascular and might be prevented by reducing the risk of developing coronary disease. Only a minority of sudden deaths occur in people with established cardiac disease, but in patients with major structural heart disease, the annual rate is high. The causes of sudden death are many in this clinical setting also, but dominated by ventricular arrhythmias and vascular events. There is good evidence that conventional treatments for heart failure, including ACE inhibitors, beta-blockers, aldosterone antagonists and cardiac resynchronisation devices reduce the risk of sudden death. Evidence that statins, aspirin or revascularisation are safe or effective in patients with heart failure is currently lacking. Implantable defibrillators confer a small but definite additional survival advantage by treating arrhythmias that have not been prevented.