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Chapter-142 Sudden Cardiac Death: How to Prevent?

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Pandurangi Ulhas M
ISBN
9789351526186
DOI
10.5005/jp/books/12415_143
Edition
1/e
Publishing Year
2015
Pages
3
Author Affiliations
1. The Madras Medical Mission, Chennai, Tamil Nadu, India, Arrhythmia—Heart Failure Academy; The Madras Medical Mission, Chennai, Tamil Nadu, India, Arrhythmia–Heart Failure Academy, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India, Arrhythmia-Heart Failure Academy, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu, India, Arrhythmia–Heart Failure Academy, The Madras Medical Mission, Chennai, Tamil Nadu, India, Madras Medical Mission, Chennai, Tamil Nadu, India
Chapter keywords
SCD, Implantable cardioverter defibrillator, CAD, RFA, adjunctive therapy, Imaging technique, ventricular arrhythmia

Abstract

SCD is sudden death due to the unexpected pulseless event. Epidemiology describes SCD which is responsible for mortality from cardiovascular disease. Risk factors include CAD and heart failure. Implantable cardioverter defibrillator is for SCD prevention based on the ICD therapy. Pharmacotherapy is management of malignant arrhythmia capable of causing SCD. Epinephrine, antiarrhythmic drugs, vasodilators and measures to correct acid-base-electrolyte balance prevent death by improving perfusion, facilitating stable rhythm with or without external direct current shock. RFA is considered as first-line therapy for patients with VT shows low risk for sudden death and also considered as an adjunctive therapy in patients with ICD in a post MI patient is to reduce symptoms related to VT and ICD shocks. Surgical therapy for ventricular arrhythmia is considered along with bypass surgery or valvular surgery includes non-electrophysiologically guided subtotal endocardectomy and cryoablation and in addition to endoventricular patches plasty of the left ventricle if needed. In future, imaging techniques to quantify cardiac structure and function, myocardial fibrosis and ischemia can be used.

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