Description of the Disease
Sudden cardiac death is a non-violent death that occurs due to cardiac causes within 1 hour of symptom onset.
Causes of the Disease
Causes of SCD may include coronary syndromes, cardiomyopathies (hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular dysplasia), myocarditis, aortic dissection, inherited channelopathies (Brugada syndrome, long QT syndrome, short QT syndrome, catecholaminergic polymorphic ventricular tachycardia), and heart defects.
The most common immediate cause of circulatory arrest is the development of ventricular rhythm disturbances – ventricular tachycardia and ventricular fibrillation, less frequently – bradyarrhythmia and electromechanical dissociation.
Sudden cardiac death accounts for 1/4 of all deaths from cardiovascular diseases.
Risk Definition
Reliable prediction of SCD risk is a very complex and unresolved issue in arrhythmology. After all, in almost half of cases, patients who survived cardiac arrest were not aware of any heart disease.
Patients who survive cardiac arrest (after successful resuscitation) require comprehensive examination, including echocardiography, prolonged ECG monitoring, coronary angiography, cardiac MRI, genetic testing, and examination of relatives.
Treatment of the Disease
Implantation of a cardioverter-defibrillator is necessary for the prevention of recurrent episodes of circulatory arrest (secondary prevention of SCD).
A cardioverter-defibrillator is a device with all the functions of a traditional pacemaker, supplemented by the ability to automatically recognize life-threatening arrhythmia and eliminate it by antitachycardia pacing or delivering a life-saving shock (defibrillation).
Radiofrequency ablation may be used in patients with implanted devices to prevent defibrillator activation.