Cardiac Arrest: Prevalence, Risk Factors and Prevention (pp.1-48)
Authors: (Vanessa Posdziech, Pascal Meier, Pier D. Lambiase, The Heart Hospital, University College Hospital & Institute of Cardiovascular Sciences, UCL, London, United Kingdom)
Abstract: Sudden cardiac death is a devastating event that often affects individuals who have not been previously identified as being at risk. It is defined by sudden death in the community or emergency department that occurs within one hour of onset of symptoms and is due to any form of cardiac disease . The underlying pathology is usually dormant prior to the event.
The most common cause of sudden cardiac death is coronary artery disease, but various other structural abnormalities like dilated or congenital cardiomyopathy as well as electrophysiological disorders are also well recognised - in particular in the age group under 40. Indeed up to 40% of sudden deaths occur in individuals with structurally normal hearts implying primary electrical disorders responsible for sudden death. Although the conditions may vary in their clinical manifestations, specific arrhythmia triggers and risk management, their final pathway frequently remains the same and includes acute arrhythmia and cardiovascular collapse. The low cardiac arrest survival rate stresses the need for early identification and effective risk stratification so as to initiate timely preventative interventions. In this chapter the epidemiology of sudden cardiac death will be reviewed, followed by risk stratification approaches and the prevention of sudden death in specific common conditions.