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Prävention des plötzlichen Herztods

Prevention of sudden cardiac death

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Zusammenfassung

Der plötzliche Herztod (PHT) stellt ein sehr großes, bisher ungelöstes Problem der öffentlichen Gesundheit dar. Die Prävention des PHT wird in 2 Hauptkategorien unterteilt, und zwar zum einen in die Primär- (Prävention eines ersten Ereignisses von PHT) und zum anderen in die Sekundärprävention (Prävention von Wiederholungsereignissen bei Überlebenden eines Herzstillstands). In diesem Übersichtsartikel wird der aktuelle Wissensstand über die Primär- und Sekundärprävention des PHT in verschiedenen klinischen Situationen zusammengefasst.

Abstract

Sudden cardiac death is a major as yet unsolved public health problem. Prevention of sudden cardiac death is subdivided into two main categories, on the one hand primary prevention (prevention of a first event of sudden cardiac death) and on the other hand secondary prevention (prevention of reoccurring events in survivors of cardiac arrest). This review article summarizes the current state of knowledge on primary and secondary prevention of sudden cardiac death in various clinical settings.

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Literatur

  1. Priori SG, Blomström-Lundqvist C, Mazzanti A et al (2016) 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Rev Esp Cardiol (Engl Ed) 69(2):176. https://doi.org/10.1016/j.rec.2016.01.001

    Article  Google Scholar 

  2. Al-Khatib SM, Stevenson WG, Ackerman MJ et al (2018) 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society. Heart Rhythm 15(10):e190–e252. https://doi.org/10.1016/j.hrthm.2017.10.035

    Article  PubMed  Google Scholar 

  3. Dagres N, Peek N, Leclercq C, Hindricks G (2020) The PROFID project. Eur Heart J 41(39):3781–3782. https://doi.org/10.1093/eurheartj/ehaa645

    Article  PubMed  PubMed Central  Google Scholar 

  4. Priori SG, Blomstrom-Lundqvist C (2015) 2015 European society of cardiology guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death summarized by co-chairs. Eur Heart J 36(41):2757–2759. https://doi.org/10.1093/eurheartj/ehv445

    Article  PubMed  Google Scholar 

  5. Bob-Manuel T, Jenkins JS, Morin DP (2019) Non-arrhythmic causes of sudden death: a comprehensive review. Prog Cardiovasc Dis 62(3):265–271. https://doi.org/10.1016/j.pcad.2019.05.004

    Article  PubMed  Google Scholar 

  6. Nogami A, Kurita T, Abe H et al (2021) JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias. J Arrhythm 37(4):709–870. https://doi.org/10.1002/joa3.12491

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nielsen JC, Lin YJ, de Oliveira Figueiredo MJ et al (2020) European heart rhythm association (EHRA)/heart rhythm society (HRS)/asia pacific heart rhythm society (APHRS)/latin American heart rhythm society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population. Europace 22(8):1147–1148. https://doi.org/10.1093/europace/euaa065

    Article  PubMed  PubMed Central  Google Scholar 

  8. McDonagh TA, Metra M, Adamo M et al (2021) 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 42(36):3599–3726. https://doi.org/10.1093/eurheartj/ehab368

    Article  CAS  Google Scholar 

  9. Priori SG, Blomström-Lundqvist C, Mazzanti A et al (2015) 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European society of cardiology (ESC). Endorsed by: association for European paediatric and congenital cardiology (AEPC). Eur Heart J 36(41):2793–2867. https://doi.org/10.1093/eurheartj/ehv316

    Article  PubMed  Google Scholar 

  10. Disertori M, Rigoni M, Pace N et al (2016) Myocardial fibrosis assessment by LGE is a powerful predictor of ventricular tachyarrhythmias in Ischemic and nonischemic LV dysfunction: a meta-analysis. JACC Cardiovasc Imaging 9(9):1046–1055. https://doi.org/10.1016/j.jcmg.2016.01.033

    Article  PubMed  Google Scholar 

  11. Prystowsky EN, Nisam S (2000) Prophylactic implantable cardioverter defibrillator trials: MUSTT, MADIT, and beyond. Multicenter unsustained tachycardia trial. Multicenter automatic defibrillator implantation trial. Am J Cardiol 86(11):1214–1215. https://doi.org/10.1016/s0002-9149(00)01205-4

    Article  CAS  PubMed  Google Scholar 

  12. Bui AH, Cannon CP, Steg PG et al (2016) Relationship between early and late nonsustained ventricular tachycardia and cardiovascular death in patients with acute coronary syndrome in the platelet inhibition and patient outcomes (PLATO) trial. Circ Arrhythm Electrophysiol 9(2):e2951. https://doi.org/10.1161/CIRCEP.115.002951

    Article  CAS  PubMed  Google Scholar 

  13. Dagres N, Hindricks G (2013) Risk stratification after myocardial infarction: is left ventricular ejection fraction enough to prevent sudden cardiac death? Eur Heart J 34(26):1964–1971. https://doi.org/10.1093/eurheartj/eht109

    Article  PubMed  Google Scholar 

  14. Sabbag A, Suleiman M, Laish-Farkash A et al (2015) Contemporary rates of appropriate shock therapy in patients who receive implantable device therapy in a real-world setting: from the Israeli ICD registry. Heart Rhythm 12(12):2426–2433. https://doi.org/10.1016/j.hrthm.2015.08.020

    Article  PubMed  Google Scholar 

  15. Moss AJ, Schuger C, Beck CA et al (2012) Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med 367(24):2275–2283. https://doi.org/10.1056/NEJMoa1211107

    Article  CAS  PubMed  Google Scholar 

  16. Willems D, Bak M, Tan H et al (2021) Ethical issues in two parallel trials of personalised criteria for implantation of implantable cardioverter defibrillators for primary prevention: the PROFID project‑a position paper. Open Heart 8(2):e1686. https://doi.org/10.1136/openhrt-2021-001686

    Article  PubMed  PubMed Central  Google Scholar 

  17. Goldberger JJ, Subacius H, Patel T et al (2014) Sudden cardiac death risk stratification in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol 63(18):1879–1889. https://doi.org/10.1016/j.jacc.2013.12.021

    Article  PubMed  Google Scholar 

  18. Di Marco A, Anguera I, Schmitt M et al (2017) Late gadolinium enhancement and the risk for ventricular arrhythmias or sudden death in dilated cardiomyopathy: systematic review and meta-analysis. JACC Heart Fail 5(1):28–38. https://doi.org/10.1016/j.jchf.2016.09.017

    Article  PubMed  Google Scholar 

  19. Kuruvilla S, Adenaw N, Katwal AB et al (2014) Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: a systematic review and meta-analysis. Circ Cardiovasc Imaging 7(2):250–258. https://doi.org/10.1161/CIRCIMAGING.113.001144

    Article  PubMed  Google Scholar 

  20. Marume K, Noguchi T, Tateishi E et al (2018) Mortality and sudden cardiac death risk stratification using the noninvasive combination of wide QRS duration and late gadolinium enhancement in idiopathic dilated cardiomyopathy. Circ Arrhythm Electrophysiol 11(4):e6233. https://doi.org/10.1161/CIRCEP.117.006233

    Article  PubMed  Google Scholar 

  21. Ichinose A, Otani H, Oikawa M, Takase K, Saito H, Shimokawa H, Takahashi S (2008) MRI of cardiac sarcoidosis: basal and subepicardial localization of myocardial lesions and their effect on left ventricular function. AJR Am J Roentgenol 191(3):862–869. https://doi.org/10.2214/ajr.07.3089

    Article  PubMed  Google Scholar 

  22. Tung R, Bauer B, Schelbert H, Lynch JP 3rd, Auerbach M, Gupta P, Schiepers C, Chan S, Ferris J, Barrio M, Ajijola O, Bradfield J, Shivkumar K (2015) Incidence of abnormal positron emission tomography in patients with unexplained cardiomyopathy and ventricular arrhythmias: the potential role of occult inflammation in arrhythmogenesis. Heart Rhythm 12(12):2488–2498. https://doi.org/10.1016/j.hrthm.2015.08.014

    Article  PubMed  PubMed Central  Google Scholar 

  23. Naruse Y, Sekiguchi Y, Nogami A et al (2014) Systematic treatment approach to ventricular tachycardia in cardiac sarcoidosis. Circ Arrhythm Electrophysiol 7(3):407–413. https://doi.org/10.1161/circep.113.000734

    Article  PubMed  Google Scholar 

  24. Hernandez-Madrid A, Paul T, Abrams D et al (2018) Arrhythmias in congenital heart disease: a position paper of the European heart rhythm association (EHRA), association for European paediatric and congenital cardiology (AEPC), and the European society of cardiology (ESC) working group on grown-up congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace 20(11):1719–1753. https://doi.org/10.1093/europace/eux380

    Article  PubMed  Google Scholar 

  25. Van Hare GF, Javitz H, Carmelli D et al (2004) Prospective assessment after pediatric cardiac ablation: demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol 15(7):759–770. https://doi.org/10.1046/j.1540-8167.2004.03645.x

    Article  PubMed  Google Scholar 

  26. Khairy P, Van Hare GF, Balaji S et al (2014) PACES/HRS expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease: developed in partnership between the pediatric and congenital electrophysiology society (PACES) and the heart rhythm society (HRS). Endorsed by the governing bodies of PACES, HRS, the American college of cardiology (ACC), the American heart association (AHA), the European heart rhythm association (EHRA), the Canadian heart rhythm society (CHRS), and the international society for adult congenital heart disease (ISACHD). Can J Cardiol 30(10):e1–e63. https://doi.org/10.1016/j.cjca.2014.09.002

    Article  PubMed  Google Scholar 

  27. Harrison DA, Harris L, Siu SC et al (1997) Sustained ventricular tachycardia in adult patients late after repair of tetralogy of Fallot. J Am Coll Cardiol 30(5):1368–1373

    Article  CAS  PubMed  Google Scholar 

  28. Knauth AL, Gauvreau K, Powell AJ et al (2008) Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart 94(2):211–216. https://doi.org/10.1136/hrt.2006.104745

    Article  CAS  PubMed  Google Scholar 

  29. Khairy P, Landzberg MJ, Gatzoulis MA et al (2004) Value of programmed ventricular stimulation after tetralogy of fallot repair: a multicenter study. Circulation 109(16):1994–2000. https://doi.org/10.1161/01.cir.0000126495.11040.bd

    Article  PubMed  Google Scholar 

  30. Vehmeijer JT, Koyak Z, Bokma JP et al (2018) Sudden cardiac death in adults with congenital heart disease: does QRS-complex fragmentation discriminate in structurally abnormal hearts? Europace 20(FI1):f122–f128. https://doi.org/10.1093/europace/eux044

    Article  PubMed  Google Scholar 

  31. Priori SG, Wilde AA, Horie M et al (2013) HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in may 2013 and by ACCF, AHA, PACES, and AEPC in june 2013. Heart Rhythm 10(12):1932–1963. https://doi.org/10.1016/j.hrthm.2013.05.014

    Article  PubMed  Google Scholar 

  32. Anastasakis A, Papatheodorou E, Ritsatos K et al (2018) Sudden unexplained death in the young: epidemiology, aetiology and value of the clinically guided genetic screening. Europace 20(3):472–480. https://doi.org/10.1093/europace/euw362

    Article  PubMed  Google Scholar 

  33. Adler A, Rosso R, Chorin E et al (2016) Risk stratification in Brugada syndrome: clinical characteristics, electrocardiographic parameters, and auxiliary testing. Heart Rhythm 13(1):299–310. https://doi.org/10.1016/j.hrthm.2015.08.038

    Article  PubMed  Google Scholar 

  34. Sieira J, Conte G, Ciconte G et al (2017) A score model to predict risk of events in patients with Brugada Syndrome. Eur Heart J 38(22):1756–1763. https://doi.org/10.1093/eurheartj/ehx119

    Article  PubMed  Google Scholar 

  35. Schwartz PJ, Ackerman MJ (2013) The long QT syndrome: a transatlantic clinical approach to diagnosis and therapy. Eur Heart J 34(40):3109–3116. https://doi.org/10.1093/eurheartj/eht089

    Article  PubMed  Google Scholar 

  36. Hayashi M, Denjoy I, Extramiana F et al (2009) Incidence and risk factors of arrhythmic events in catecholaminergic polymorphic ventricular tachycardia. Circulation 119(18):2426–2434. https://doi.org/10.1161/circulationaha.108.829267

    Article  CAS  PubMed  Google Scholar 

  37. O’Mahony C, Jichi F, Pavlou M et al (2014) A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). Eur Heart J 35(30):2010–2020. https://doi.org/10.1093/eurheartj/eht439

    Article  PubMed  Google Scholar 

  38. Priori SG, Wilde AA, Horie M et al (2013) Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. Europace 15(10):1389–1406. https://doi.org/10.1093/europace/eut272

    Article  PubMed  Google Scholar 

  39. van Rijsingen IA, Arbustini E, Elliott PM et al (2012) Risk factors for malignant ventricular arrhythmias in lamin a/c mutation carriers a European cohort study. J Am Coll Cardiol 59(5):493–500. https://doi.org/10.1016/j.jacc.2011.08.078

    Article  CAS  PubMed  Google Scholar 

  40. van Rijsingen IA, van der Zwaag PA, Groeneweg JA et al (2014) Outcome in phospholamban R14del carriers: results of a large multicentre cohort study. Circ Cardiovasc Genet 7(4):455–465. https://doi.org/10.1161/circgenetics.113.000374

    Article  PubMed  Google Scholar 

  41. Priori SG, Wilde AA, Horie M et al (2013) Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. Europace. https://doi.org/10.1093/europace/eut272

    Article  PubMed  Google Scholar 

  42. Pinto YM, Elliott PM, Arbustini E et al (2016) Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases. Eur Heart J 37(23):1850–1858. https://doi.org/10.1093/eurheartj/ehv727

    Article  PubMed  Google Scholar 

  43. Sawant AC, Te Riele AS, Tichnell C et al (2016) Safety of American heart association-recommended minimum exercise for desmosomal mutation carriers. Heart Rhythm 13(1):199–207. https://doi.org/10.1016/j.hrthm.2015.08.035

    Article  PubMed  Google Scholar 

  44. Visseren FLJ, Mach F, Smulders YM et al (2021) 2021 ESC guidelines on cardiovascular disease prevention in clinical practice: developed by the task force for cardiovascular disease prevention in clinical practice with representatives of the European society of cardiology and 12 medical societies with the special contribution of the European association of preventive cardiology (EAPC). Eur Heart J 42(34):3227–3337. https://doi.org/10.1093/eurheartj/ehab484

    Article  PubMed  Google Scholar 

  45. Connolly SJ, Hallstrom AP, Cappato R et al (2000) meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs implantable defibrillator study. Cardiac arrest study Hamburg. Canadian implantable defibrillator study. Eur Heart J 21(24):2071–2078. https://doi.org/10.1053/euhj.2000.2476

    Article  CAS  PubMed  Google Scholar 

  46. Cronin EM, Bogun FM, Maury P et al (2020) 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. Heart Rhythm 17(1):e2–e154. https://doi.org/10.1016/j.hrthm.2019.03.002

    Article  PubMed  Google Scholar 

  47. Pannone L, D’Angelo G, Gulletta S et al (2021) Amiodarone in ventricular arrhythmias: still a valuable resource? Rev Cardiovasc Med 22(4):1383–1392. https://doi.org/10.31083/j.rcm2204143

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Abteilung für Elektrophysiologie, Herzzentrum Leipzig – Universitätsklinik, Strümpellstr. 39, 04289, Leipzig, Deutschland

    Alireza Sepehri Shamloo MD, Patrick Dilk & Nikolaos Dagres

  2. Klinik und Polyklinik für Kardiologie, Universität Leipzig, Leipzig, Deutschland

    Patrick Dilk

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  1. Alireza Sepehri Shamloo MD
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Correspondence to Alireza Sepehri Shamloo MD.

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Interessenkonflikt

A. Sepehri Shamloo, P. Dilk und N. Dagres geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Sepehri Shamloo, A., Dilk, P. & Dagres, N. Prävention des plötzlichen Herztods. Herz 47, 135–140 (2022). https://doi.org/10.1007/s00059-022-05106-w

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