title: A new system for classification of cardiac death as arrhythmic, ischemic, or due to myocardial pump failure.
abstract: Existing classifications of cardiac death fail to incorporate current understanding of the pathophysiology of sudden cardiac death. We developed a new scheme for classifying cardiac death that defines 3 categories of underlying mechanism: primary arrhythmia, acute myocardial ischemia/infarction, and myocardial pump failure. Using this new system, we classified the mechanism of 106 definite cardiac deaths from the Recurrent Coronary Prevention Project. Fifty deaths (47%) were classified as arrhythmic, 46 (43%) as ischemic, and 9 (8%) as due to myocardial pump failure (1 death was not classifiable). All 36 witnessed arrhythmic deaths were sudden and 8 of 9 witnessed myocardial pump failure deaths were nonsudden. The 38 witnessed ischemic deaths were split evenly between sudden and nonsudden. Interrater agreement for the classification of mechanism was 100%. This classification scheme, if validated in subsequent studies, will provide a useful algorithm for classifying deaths by underlying mechanism.
mesh_terms: D001145:Arrhythmias, Cardiac / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D006323:Heart Arrest / Q000145:classification* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D017202:Myocardial Ischemia / Q000401:mortality