Abstract
Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.
Highlights
Sudden cardiac death (SCD) is a natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of an acute change in cardiovascular status
As most SCDs are due to coronary heart disease (CHD), it is not surprising that they have similar risk factors such as hypertension, diabetes mellitus, obesity, smoking and psychosocial factors
The overall rate of survival from out-of-hospital cardiac arrest remains low. This underlines the importance of primary prevention, with Implantable cardioverter-defibrillator (ICD) playing an important role in high-risk patients
Summary
Sudden cardiac death (SCD) is a natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of an acute change in cardiovascular status. The most cited data are those reported by the American Heart Association; its 2020 statistical update lists 379,133 SCDs per year in the United States (114/100,000) (ref.[6]). The estimated annual burden of SCD would be approximately 4 million cases worldwide. SCD has a large preponderance in men relative to women during the young adult and early middle-age years because of the protection that women enjoy from coronary atherosclerosis before menopause. Men have a fourfold to sevenfold greater incidence of SCD than women before 65 years of age, at which point the difference decreases to 2:1 or less and continues to decrease with advancing age[1]. Dilated nonischemic and hypertrophic cardiomyopathies account for the second largest number of SCDs, whereas other cardiac disorders, including congenital heart defects and the known
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