Physical activity, time of awakening, and other possible triggers of sudden cardiac death

  • Stefan N. Willich
  • Hans-Richard Arntz
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 170)


Sudden cardiac death (SCD) is one of the most prominent disorders in Western industrialised societies, afflicting at least 300,000 individuals each year in the United States alone [1–3]. Recent analyses of several register sites of the MONICA (Monitoring of Trends and Determinants of Cardiovascular Disease) project of the World Health Organisation [4–6] demonstrate that approximately 25% of all patients with an acute coronary event die within the first hour after onset of the event (Figure 1). For these patients — victims of SCD — there is usually no adequate immediate medical treatment available. The MONICA project is a large international collaboration in over 20 countries to measure trends in cardiovascular mortality and to assess the extent to which these changes are related to changes in risk factors and medical care [4–6]. Since the study sites register all cardiac events within predefined populations, including hospitalized patients with myocardial infarction and prehospital cardiac deaths, this project allows assessment of the overall sequence of hospitalization and mortality (Figure 1).


Acute Myocardial Infarction Sudden Cardiac Death Mental Stress Circadian Variation Cardiac Arrhythmia Suppression Trial 
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© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Stefan N. Willich
  • Hans-Richard Arntz

There are no affiliations available

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