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(Circulation. 2006;114:1134-1136.)
© 2006 American Heart Association, Inc.

Editorial

Sudden Cardiac Death

Better Understanding of Risks, Mechanisms, and Treatment

John C. Lopshire, MD, PhD; Douglas P. Zipes, MD

From the Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind.

Correspondence to Douglas P. Zipes, MD, Krannert Institute of Cardiology, 1800 North Capitol Ave, Suite E315, Indianapolis, IN 46202. E-mail dzipes@iupui.edu

Key Words: Editorials • arrhythmia • death, sudden • defibrillation • electrocardiography • electrophysiology • genetics

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Sudden cardiac death (SCD) is generally defined as unexpected death as the result of cardiovascular causes in a person with or without preexisting heart disease, within 1 hour of onset of change in clinical status.¹ Most instances of SCD are thought to involve ventricular tachycardia degenerating to ventricular fibrillation (VF) and subsequent asystole, although the percent of ventricular tachyarrhythmias found as the first rhythm at the time of collapse appears to be decreasing.² In 60% to 80% of cases, SCD occurs in the setting of coronary artery disease. Nonischemic cardiomyopathy and infiltrative, inflammatory, and acquired valvular diseases account for most other SCD events.³ A small percentage of SCDs occur in the setting of ion channel mutations responsible for inherited abnormalities such as the long/short QT syndromes, Brugada syndrome, and catecholaminergic ventricular tachycardia. Although accounting for a small number of SCDs overall, these fascinating syndromes provide mechanistic insights never before available. In addition, other genetic abnormalities such as hypertrophic cardiomyopathy and congenital heart defects such as anomalous coronary arteries are responsible for SCD.

Articles p 1140 and 1146

Despite widespread advances in the treatment of ischemic heart disease with early recognition and revascularization therapies and the growing use of automated external defibrillators and implantable cardioverter-defibrillators to detect and treat ventricular arrhythmias, SCD remains a major cause of death in industrialized countries, exceeding 300 000 events per year in the United States, or about 20% of all deaths annually.³ The only pharmacological advances have been achieved with drugs that affect "upstream" regulatory . . . [Full Text of this Article]

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