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Sudden death secondary to cardiac arrhythmias: mechanisms and treatment strategies.
Curr Opin Cardiol. 2006 Sep; 21(5):517-25.CO

Abstract

PURPOSE OF REVIEW

This article reviews mechanisms and available therapeutic options for arrhythmias leading to sudden cardiac death in patients with coronary artery disease.

RECENT FINDINGS

Intensive efforts have led to a better understanding of the pathophysiology and various treatments of sudden cardiac death. Antiarrhythmic medications have not demonstrated a survival benefit. Beta-adrenergic blocking agents have been revalidated in recent studies to improve survival and reduce risk of sudden cardiac death in patients with myocardial infarction. Angiotensin-converting enzyme inhibitors and aldosterone antagonists should also be used in these patients. Data from randomized trials demonstrate significant survival benefit with an implantable cardioverter-defibrillator and indications have expanded. Patients with established ischemic cardiomyopathy do not require electrophysiologic studies for induction of tachyarrhythmias based on these trials. One recent trial did not demonstrate mortality reduction with implantable defibrillators in patients with recent myocardial infarction. Devices may not provide survival benefit in patients with advanced New York Heart Association class IV heart failure.

SUMMARY

The incidence of arrhythmia-related sudden death in the general population remains relatively high. Better risk stratification tools are needed to identify high-risk patients in the general population and in those with known coronary disease and to exclude low-risk patients.

Authors+Show Affiliations

Main Line Health Heart Center and the Lankenau Hospital and Institute for Medical Research, Main Line Health Systems, Wynnewood, Pennsylvania 19096, USA. siddiquiA@mlhs.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16900017

Citation

Siddiqui, Adnan, and Peter R. Kowey. "Sudden Death Secondary to Cardiac Arrhythmias: Mechanisms and Treatment Strategies." Current Opinion in Cardiology, vol. 21, no. 5, 2006, pp. 517-25.
Siddiqui A, Kowey PR. Sudden death secondary to cardiac arrhythmias: mechanisms and treatment strategies. Curr Opin Cardiol. 2006;21(5):517-25.
Siddiqui, A., & Kowey, P. R. (2006). Sudden death secondary to cardiac arrhythmias: mechanisms and treatment strategies. Current Opinion in Cardiology, 21(5), 517-25.
Siddiqui A, Kowey PR. Sudden Death Secondary to Cardiac Arrhythmias: Mechanisms and Treatment Strategies. Curr Opin Cardiol. 2006;21(5):517-25. PubMed PMID: 16900017.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sudden death secondary to cardiac arrhythmias: mechanisms and treatment strategies. AU - Siddiqui,Adnan, AU - Kowey,Peter R, PY - 2006/8/11/pubmed PY - 2006/12/13/medline PY - 2006/8/11/entrez SP - 517 EP - 25 JF - Current opinion in cardiology JO - Curr. Opin. Cardiol. VL - 21 IS - 5 N2 - PURPOSE OF REVIEW: This article reviews mechanisms and available therapeutic options for arrhythmias leading to sudden cardiac death in patients with coronary artery disease. RECENT FINDINGS: Intensive efforts have led to a better understanding of the pathophysiology and various treatments of sudden cardiac death. Antiarrhythmic medications have not demonstrated a survival benefit. Beta-adrenergic blocking agents have been revalidated in recent studies to improve survival and reduce risk of sudden cardiac death in patients with myocardial infarction. Angiotensin-converting enzyme inhibitors and aldosterone antagonists should also be used in these patients. Data from randomized trials demonstrate significant survival benefit with an implantable cardioverter-defibrillator and indications have expanded. Patients with established ischemic cardiomyopathy do not require electrophysiologic studies for induction of tachyarrhythmias based on these trials. One recent trial did not demonstrate mortality reduction with implantable defibrillators in patients with recent myocardial infarction. Devices may not provide survival benefit in patients with advanced New York Heart Association class IV heart failure. SUMMARY: The incidence of arrhythmia-related sudden death in the general population remains relatively high. Better risk stratification tools are needed to identify high-risk patients in the general population and in those with known coronary disease and to exclude low-risk patients. SN - 0268-4705 UR - https://www.unboundmedicine.com/medline/citation/16900017/Sudden_death_secondary_to_cardiac_arrhythmias:_mechanisms_and_treatment_strategies_ L2 - http://dx.doi.org/10.1097/01.hco.0000240591.06839.39 DB - PRIME DP - Unbound Medicine ER -