Can We Prevent All Sudden Cardiac Deaths?
In both ischemic and non-ischemic heart disease the severity of LV dysfunction has emerged as the key determinant affecting the decision of which patient should receive an ICD for prophylaxis against a future risk of arrhythmic sudden death. A documented EF of less than 35% in an otherwise suitably treated patient will commonly result in an electrophysiology referral and an ICD implant.
Although such treatment has yielded mortality benefit in the qualifying patient, whether it can significantly impact on overall sudden death in the general population is less clear. A population based study unfortunately showed that only a small proportion of sudden death victims could have benefited from the current primary prevention ICD guidelines.
Of 714 sudden deaths occurring over a two year period, only 121 patients had a previous assessment of LV function and only 36 of these patients (5 % of the total) had an EF of less than 35 %. The concept that only a minority of sudden deaths occurs in patients previously identified as having significant I.V dysfunction has been previously well documented in a number of studies.
So far it remains far less than perfect at predicting at what time and for which patient the unfortunate substrates and triggers cross to result in sudden death. The second corollary is that not all SCDs are from arrhythmias. Clearly, these patients died of AML, which could not be prevented by ICD.
REGISTER YOUR PROFILE WITH US FOR FREE MEDICAL CONSULTATIONS
REGISTER FOR APPSREAD MEMBERSHIP FEE OF $ 10
Related Posts
About The Author
