Physical activity, time of awakening, and other possible triggers of sudden cardiac death
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).
KeywordsAcute Myocardial Infarction Sudden Cardiac Death Mental Stress Circadian Variation Cardiac Arrhythmia Suppression Trial
Unable to display preview. Download preview PDF.
- 3.Myerburg RJ, Kessler KM, Castellanos A. Sudden cardiac death: Structure, function and time dependence of risk. Circulation 1992; 85(Suppl I): I-2–I-10.Google Scholar
- 4.WHO MONICA Project, prepared by Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A. Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates and case fatality in 38 populations from 21 countries in 4 continents. Circulation 1994; 90: 583–612.PubMedGoogle Scholar
- 12.Gebara OCE, Mittleman M, Rasmussen C, Venditti FJ, Muller JE, Toiler GH. Morning peak in ventricular arrhythmias detected by time of implantable cardioverter-defibrillator therapy. J Am Coll Cardiol 1994; 1: 204A (Abstract).Google Scholar
- 13.Hausmann D, Trappe HJ, Bargheer K, Daniel WG, Wenzlaff P, Lichtlen PR. Circadian variation of ventricular tachycardia in patients after myocardial infarction. J Am Coll Cardiol 1992; 19(Suppl A): 368A (Abstract).Google Scholar
- 17.Arntz HR, Willich SN, Stern R et al. Risk of sudden death: Seasonal and weekly variation. Eur Heart J 1995; 16 (Suppl): 499 (Abstract).Google Scholar
- 20.See .Google Scholar
- 22.Maclure M, Sherwood JB, Andrade S, Goldberg J, Toller GH, Muller JE. Increased risk of myocardial infarction onset within the two hours after awakening. Circulation 1990; 82(Suppl III): III-281 (Abstract).Google Scholar
- 23.Willich SN, Löwel H, Lewis M et al. Association of wake-time and the onset of myocardial infarction: TRIMM (Triggers and Mechanisms of Myocardial Infarction) Pilot Study. Circulation 1991; 84(Suppl VI): VI-62–VI-67.Google Scholar
- 25.Muller JE, Tofler GH, Stone PH. Circadian variation and triggers of onset of acute cardiovascular disease. Circulation 1989; 86: 22–8.Google Scholar
- 29.Moritz AR, Zamcheck N. Sudden and unexpected deaths of young soldiers: Diseases responsible for such deaths during World War II. Arch Pathol 1946; 42: 459–94.Google Scholar
- 34.Romo M. Factors related to sudden death in acute ischaemic heart disease. Acta Med Scand 1972; 547(Suppl): 7–92.Google Scholar