Sudden Cardiac Death

Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.

The first invasive evaluation of cardiac arrhythmias in humans was performed in 1967 in Paris (Prof. P. Coumel) and Amsterdam (Prof. D. Durrer). This was the start of a rapid increase in our knowledge of the diagnosis, mechanism and treatment of cardiac arrhythmias. In that same year Prof. Hein J.J. Wellens became cardiologist in the Wilhelmina Gasthuis in Amsterdam. Initially in Amsterdam (1967-1977) and later on in Maastricht (from 1977), he was the driving force for many breakthroughs in clinical cardiac electrophysiology. With an active interplay between the knowledge derived from the 12-lead electrocardiogram and the recordings made with invasive electrophysiology, he composed new ideas leading to major contributions in clinical cardiac electrophysiology and, more generally, in arrhythmology. He published over 650 scientific papers and 14 books, and had numerous functions within scientific boards of prestigious journals. In addition he trained more than 120 cardiologists in clinical cardiac electrophysiology. On the occasion of the congress `2000, Future of Arrhythmology: Lessons From the Past, Promises For Tomorrow', we highlight the scientific work of Prof. Hein J.J. Wellens. A selection of more than 60 articles over the whole time span has been selected. These articles are accompanied by comments from an expert, co-worker and/or former fellow in order to place the paper in a scientific time frame, including the relationship of the author with Prof. Hein J.J. Wellens.

Perfect for residents, generalists, anesthesiologists, emergency department physicians, medical students, nurses, and other healthcare professionals who need a practical, working knowledge of cardiology, Netter's Cardiology, 3rd Edition, provides a concise overview of cardiovascular disease highlighted by unique, memorable Netter illustrations. This superb visual resource showcases the well-known work of Frank H. Netter, MD, and his successor, Carlos Machado, MD, a cardiologist who has created clear, full-color illustrations in the Netter tradition. New features and all-new chapters keep you up to date with the latest information in the field. Includes 13 all-new chapters: Basic Anatomy and Embryology of the Heart, Stem Cell Therapies for Cardiovascular Disease, Diabetes and Cardiovascular Events, Clinical Presentation of Adults with Congenital Heart Disease, Transcatheter Aortic Valve Replacement, Deep Vein Thrombosis and Pulmonary Embolism, and more. Features new coverage of 3-D TEE imaging for structural heart procedures. Contains color-coded diagnostic and therapeutic algorithms and clinical pathways. Uses an easy-to-follow, templated format, covering etiology, pathogenesis, clinical presentation, diagnostic approach, and management/therapy for each topic. Offers dependable clinical advice from Drs. George A. Stouffer, Marschall S. Runge, Cam Patterson, and Joseph S. Rossi, as well as many world-renowned chapter contributors.

Sudden death in athletes is a global problem. Although it is a relatively rare phenomenon (1/100,000 persons), when it does occur, it is often as an incomprehensible event. In fact, it strikes subjects who presumably should be much healthier than the general population. In the previous 20 years, many authors have studied this problem in an attempt to understand the causes and prevent these events, and it has been determined that, in the vast majority of cases, athletes who die suddenly have an underlying heart disease (arrhythmogenic cardiomyopathy, hypertrophic cardiomyopathy, coronary anomalies, channelopathies, etc.). In most cases these diseases do not produce major symptoms and do not preclude sports activity even at the highest levels, although they do increase the incidence of sudden death. How to discover these diseases in asymptomatic athletes is a hotly debated issue. In particular, there is controversy as to whether all athletes should undergo detailed medical screening, including electrocardiogram, or whether the costs of this screening are too high in relation to the event incidence. The purpose of this book is to accurately analyze the causes of sudden death in athletes and to provide cardiologists and sports physicians with useful tips on how to identify at-risk individuals.

Clearly presents the pathology of heart disease from fetus to adolescence, integrating histology and macroscopy with effects of treatment.

Clinical cardiologists are encountering an important challenge in the caring of families with inherited cardiac diseases. The majority of the inherited cardiac diseases causing sudden death express themselves at variable ages in the form of altered muscle function (i.e hypertrophic or dilated cardiomyopathy) or in the form of arrhythmias (i.e. Brugada syndrome, long QT syndrome). However, it is not uncommon that the first sign of the disease may actually be sudden cardiac death, even before the identification of clear clinical abnormalities. In this last decade, with more than 50 new disease-associated genes identified, the possibility of genetic testing has opened a new opportunity to disease diagnosis and prevention. Clinical and genetic research is continuously on-going not only to identify those at risk, but to better define their level or risk still with limited success.

This is a detailed clinical compilation on sudden cardiac death causes. From the various geographical regions of the world comes different clinical perspectives toward the SCD problem that shed light on the predictors and estimated prevalence in genetic inheritance worldwide. For many centuries, the mysterious deaths of prominent professional sportsmen have preoccupied the attention of the media and medical professionals. In some cases, it was possible to obtain the medical histories of the victims, data on the presence of some specific diseases, and conditions or potential symptoms preceding the fatal episode. Various rare inherited syndromes that are associated with congenital heart disease are focused on in this study, and the interrelationship between ventricular premature beats, sustained/non-sustained ventricular tachycardias and ventricular fibrillations are discussed. Cardio-oncology is an emerging field where more and more patients face consequences from radiotherapy and chemotherapy because these individuals become more prone to SCD. Among the most notable developments, three-dimensional echocardiography and myocardial strain imaging are worth noting and might inexpensively improve the current risk stratification process. Recently, a strain that reflects the change of length and thickness of myocardial fibres has been incorporated into the routine clinical practice. The risk of sudden cardiac death is not the same in patients with Chagas disease, and newly predicted factors are to blame. The prevalence of SCD, hypertrophic cardiomyopathy and the accurate risk are extremely challenging, so much so that they recently became a source of argument between European and American experts. This is a must-have book for those interested in a clinical approach to the SCD phenomenon.