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Current challenges in sudden cardiac death prevention

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Abstract

Ischemic heart disease and non-ischemic dilated cardiomyopathy are the most common causes of arrhythmic sudden cardiac death (SCD). Implantable cardioverter defibrillator (ICD) therapy is the only strategy that proved to be effective in preventing SCD in high-risk individuals while the role of antiarrhythmic drugs is limited to symptoms relief. Current guidelines recommend selecting candidates to ICD implantation based on etiology, symptoms of heart failure (NYHA class), and severely depressed left ventricular ejection fraction, but these parameters are neither sensitive nor specific. The review addresses the mechanisms of SCD in patients with heart failure of either ischemic or non-ischemic etiology, risk stratification, and strategies for prevention of SCD in the clinical practice (including optimization of heart failure therapy, avoidance of triggering factors, antiarrhythmic drugs, ICD therapy, early resuscitation, and public access defibrillators).

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Authors and Affiliations

  1. Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova, Via N. Giustiniani 2, 35121, Padova, Italy

    Domenico Corrado & Alessandro Zorzi

  2. Molecular Medicine Department, Università degli Studi di Pavia, Pavia, Italy

    Emilio Vanoli

  3. Cardiovascular Department, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy

    Emilio Vanoli & Edoardo Gronda

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  1. Domenico Corrado
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  2. Alessandro Zorzi
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  3. Emilio Vanoli
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  4. Edoardo Gronda
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Correspondence to Domenico Corrado.

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Corrado, D., Zorzi, A., Vanoli, E. et al. Current challenges in sudden cardiac death prevention. Heart Fail Rev 25, 99–106 (2020). https://doi.org/10.1007/s10741-019-09830-0

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