[Heart failure and sudden death].
Sudden death in patients with heart failure (HF) is a topic of great complexity. Neurohumoral activation including adrenergic and renin-angiotensin-aldosterone system has been a suspected trigger for lethal ventricular arrhythmias and sudden deaths. Randomized clinical trials have demonstrated that angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists and beta-adrenergic blockers improve survivals in patients with HF. Although prophylactic implantable cardioverter defibrillator (ICD) therapy is effective reducing mortality in patients with left ventricular (LV) systolic dysfunction, the ICD is unlikely to be appropriate for all patients with LV systolic dysfunction. In addition, the effect of routine prophylactic use of ICDs on health care costs must be carefully considered. The care of patients with LV systolic dysfunction should be individualized for each patient.
Hirai
Tadakazu
T
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University.
Asanoi
Hidetsugu
H
D001145:Arrhythmias, Cardiac / Q000209:etiology; D016757:Death, Sudden, Cardiac; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D016032:Randomized Controlled Trials as Topic