Sudden Cardiac Death: Prognosis of Long-term Antiarrhythmic Therapy
According to cause-of-death statistics in the Federal Republic of Germany for the year 1979, the percentage of deaths due to cardiovascular disease has risen from 39% to 49% over the past 20 years. This rise in cardiovascular mortality is attributed to an increase in ischémic heart disease from 22% to 35% during the same period (Cause-of-Death Statistics, 1981). Studies by Lovegrove and Thompson (1978) have shown that approximately 71% of these persons die within 30 minutes after the onset of symptoms, i.e., have what is termed a “sudden death.” In 87% of persons who died within 1 h, evidence pointed to a cardiac arrhythmia as the immediate cause of death (Aspirin Myocardial Infarction Study Research Group, 1980). Death in such cases is due to a potentially treatable electrical instability of the heart, rather than to a terminal stage of organic failure. Much research, therefore, has been directed toward the recognition of patient groups that are at risk of sudden cardiac death, as well as toward the development of treatment regimes aimed at preventing such deaths.
KeywordsAcute Myocardial Infarction Sudden Death Ventricular Tachycardia Ventricular Arrhythmia Sudden Cardiac Death
Unable to display preview. Download preview PDF.
- Collaborative Group, (1971) Phenytoin after recovery from myocardial infarction. Lancet 2: 1055–1057Google Scholar
- Hjalmarson Å, Elmfeldt D, Herlitz J, Holmberg S, Málek I, Nyberg G, Rydén L, Swedberg K, Vedin A, Waagstein F, Waldenström A, Waldenström J, Wedel H, Wilhelmsen L, Wilhelmsson C, (1981) Effect on mortality of metoprolol in acute myocardial infarction: A double-blind randomised trial. Lancet 17: 823–827CrossRefGoogle Scholar
- Horowitz LN, Josephson ME, Farshidi A, Spielman SR, Michelson EL, Greenspan AM, (1978) Recurrent sustained ventricular tachycardia 3. Role of the electrophysiologic study in selection of antiarrhythmic regimes. Circulation 58: 987–997Google Scholar
- Kosowsky BD, Taylor J, Lown B, Ritchie RF, (1971) Long-term use of procainamide following acute myocardial infarction. Circulation 47: 1204–1210Google Scholar
- Kotier MN, Tabatznik B, Mower MM, Tominaga S, (1973) Prognostic significance of ventricular ectopic beats with respect to sudden death in the late postinfarction period. Circulation 47: 959–966Google Scholar
- Report of the Joint International Society and Federation of Cardiology World Health Organization Task Force on Standardization of Clinical Nomenclature (1979) Nomenclature and criteria for diagnosis of ischémic heart disease. Circulation 59: 607–609Google Scholar
- Todesursachenstatistik (Cause-of-death statistics) (1981) Dtsch Med Wochenschr 106: 157–158Google Scholar
- Van Durme JP, Bogaert MG, (1980) Prevention of sudden death. The role of antiarrhythmic therapy. In: Kulbertus HE, Wellens HJJ (eds) Sudden death. Nyhoff, The Hague p 331Google Scholar