Abstract

GARILLO, Raúl. Sudden cardiac death: the 7 questions all cardiologists must have an answer to. Arch. Cardiol. Méx. [online]. 2010, vol.80, n.3, pp.199-204. ISSN 1665-1731.

The implantable cardioverter defibrillator (ICD), has changed the view related to prevention and treatment of sudden cardiac arrest (SCA). However, some issues are still matter of discussion. Answers for the main questions are briefly exposed. 1. According to worldwide statistics, the annual incidence of SCA varies between 750 and 1000 people per million inhabitants. 2. Nearly 25% of SCA are related to individuals with severe heart disease and low ejection fraction, but in the remaining 75% there are scarce or no antecedents at all, plus normal left ventricular function. 3. In subjects with history of severe heart disease, the risk of SCA does not decrease along the time. 4. Pharmacological treatment did not prove to be safe for SCA prevention and cannot replace the ICD indication. 5. Except in particular cases, EP testing is not the right tool for risk stratification of SCA. 6. In the population with minor or without antecedents of heart disease, family history of SCA below 40 years old, or some features in the ECG (delta wave, long QT interval, etc), would be the unique sign of risk for developing SCA. 7. Although inappropriate shocks and eventually myocardial injury due to shock therapy may occur, the ICD still is the best therapy for prevention and treatment of SCA.

Keywords : Sudden cardiac arrest; Implantable cardioverter defibrillator.