Survivors of sudden cardiac death: a rational approach to evaluation and therapy of patients surviving ventricular fibrillation.
Survivors of out-of-hospital cardiac arrest that is not associated with acute myocardial infarction are at high risk for subsequent life-threatening ventricular tachyarrhythmias. A rational approach to evaluating the underlying disease processes and to formulating a specific treatment plan for these patients is presented. A protocol is suggested whereby existing cardiac conditions are appropriately treated and hemodynamic parameters are optimized. Myocardial ischemia is minimized with drugs or revascularization; this may suffice to prevent recurrence of sudden cardiac death in a small group of patients. For remaining patients at high risk of recurrence, the implantable cardioverter-defibrillator is the therapy associated with the lowest rate of mortality.
Rabinowitz
A J
AJ
Department of Cardiology, Cleveland Clinic Foundation, OH 44195.
Maloney
J D
JD
D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D012008:Recurrence; D013610:Tachycardia / Q000628:therapy; D014693:Ventricular Fibrillation / Q000628:therapy*