Half of all cardiac deaths are sudden, accounting for approximately 300,000 deaths per year in the United States. SCD is death due to instantaneous, unanticipated circulatory collapse within 1 hour of initial symptoms and is often, but not always, due to a cardiac arrhythmia. More than 70% of all sudden natural deaths have a cardiac cause, and 80% of these are attributable to coronary artery disease. Approximately 70% of SCDs occur in men. Compared with routine activities, vigorous exercise increases the immediate risk of SCD 17-fold.
[...] The most important factor that determines the outcome of cardiac arrest secondary to VF or pulseless VT is the time to defibrillation, however. Emerging data from newer defibrillators using biphasic waveforms that deliver 150 to 200J suggest they are at least as effective as standard defibrillators that deliver 200 to 360J. Optimal chances for survival occur when CPR is initiated within 4 minutes of the arrest, and advanced cardiac life support, including intubation, intravenous medications, and defibrillation, is implemented within 8 minutes. [...]
[...] SCD is death due to instantaneous, unanticipated circulatory collapse within 1 hour of initial symptoms and is often, but not always, due to a cardiac arrhythmia. More than 70% of all sudden natural deaths have a cardiac cause, and 80% of these are attributable to coronary artery disease. Approximately 70% of SCDs occur in men. Compared with routine activities, vigorous exercise increases the immediate risk of SCD 17-fold. In more recent years, the incidence of SCD has declined in parallel with the decrease in coronary artery disease, likely secondary to a reduction in cardiac risk factors, more effective secondary preventive measures, improved resuscitative efforts, and expansion of emergency medical services. [...]
[...] Cápsulas SUDDEN CARDIAC DEATH Definitions, Incidence, and Prevalence Half of all cardiac deaths are sudden, accounting for approximately 300,000 deaths per year in the United States. SCD is death due to instantaneous, unanticipated circulatory collapse within 1 hour of initial symptoms and is often, but not always, due to a cardiac arrhythmia. More than 70% of all sudden natural deaths have a cardiac cause, and 80% of these are attributable to coronary artery disease. Approximately 70% of SCDs occur in men. [...]
[...] As the Cardiac Arrhythmia Suppression Trial (CAST) showed, however, suppression of a ventricular ectopy does not improve prognosis. Despite this caveat, data from the Multicenter Automatic Defibrillator Implantation Trial (MADIT) and the Multicenter Unsustained Tachycardia Trial (MUSTT) indicate that surveillance Holter recordings should be obtained in patients with ischemic heart disease and an ejection fraction less than or equal to 40%. Patients with at least 3 beats per minute of nonsustained VT should undergo electrophysiologic testing for further risk stratification. [...]
[...] Secondary prevention trials for sudden death survivors secondary to VF/VT or patients with hemodynamically unstable VT in the aggregate show a 20 to 30% reduction in mortality at 3 years with ICD therapy compared with amiodarone. Antiarrhythmic therapy is seldom considered a reliable means of secondary prevention, athough some data suggest that amiodarone is as effective as ICD therapy in patients with relatively well-preserved left ventricular function (ejection fraction Currently, it is reasonable to conclude, however, that in appropriately identified patients, the ICD has emerged as the most effective therapy for primary and secondary prevention of SCD. [...]
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