Role of Traditional Heart Failure Medications on Sudden Cardiac Death Prevention in Patients with Cardiomyopathy

Abstract

Sudden cardiac death (SCD) remains a major public health issue with an estimated annual inci‐ dence of 300,000 cases per year. The ACC/AHA/ESC 2006 guidelines define SCD as “death from an unexpected circulatory arrest, usually due to a cardiac arrhythmia occurring within an hour of the onset of symptoms” [1]. Trials on traditional antiarrhythmic drugs have failed to show any mortality benefit even when compared to placebo or implantable cardiovertor defibrilla‐ tors (ICDs) [2]. Most of the patients experiencing sudden cardiac arrest have left ventricular ejection fraction (LVEF) > 50%, with the majority of these patients having a history of coronary artery disease (CAD). Majority of Sudden Cardiac Arrests (85-90%) are the first arrhythmic event a patient experiences[3].Beta blocker therapy, Angiotensin enzymes inhibitors (ACE-I) as well as aldosterone antagonists have been shown to decrease the risk of sudden cardiac death especially in post myocardial infarction (MI) patients and in patients with congestive heart fail‐ ure. This chapter will review the data on the effects of traditional heart failure medications, es‐ pecially beta blockers, Renin Angiotensin system blockers, as well as Statin therapy on sudden cardiac death in post MI patients and in patients with cardiomyopathy.