[Sudden cardiac death (SCD) and guidelines for SCD].
Sudden cardiac death is mainly caused by arrhythmic events, triggered by ischemia. About half of the affected persons had no previous diagnosis of coronary heart disease, thus rendering them practically unreachable for specific preventive measures. This fact makes it necessary to optimize reanimation conditions. The establishment of international reanimation standards (ILCOR) has stimulated an intensified scientific evaluation of therapeutic options. While the use of vasopressin, adrenaline and reanimation by bystanders is being evaluated at the moment, amiodarone has not fulfilled the expectation of reducing mortality. Secondary prevention of sudden cardiac death after cardiac events is based on betablockers, ACE inhibitors and antilipemic therapy. Guidelines on prevention of sudden cardiac death also recommend aldosterone blockade and n-3-fatty acids. Persons at highest risk gain most from the use of ICDs, yet it has not been shown that their use immediately after myocardial infarction reduces mortality.
Andresen
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Medizinische Klinik I, Vivantes Klinikum am Urban, Dieffenbacher Str. 1, 10967 Berlin, Germany.
D001145:Arrhythmias, Cardiac / Q000401:mortality; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002423:Cause of Death; D003327:Coronary Disease / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007391:International Cooperation; D017410:Practice Guidelines as Topic / Q000592:standards*; D018570:Risk Assessment; D055502:Secondary Prevention; D016019:Survival Analysis
D002317:Cardiovascular Agents