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Sudden Death in Heart Failure: Risk Stratification and Treatment Strategies
- Source :
- Perioperative Critical Care Cardiology ISBN: 9788847005570
- Publication Year :
- 2007
- Publisher :
- Springer Milan, 2007.
-
Abstract
- Attempting a careful evaluation of the incidence of sudden death (SD) in congestive heart failure is inevitably a complex and imprecise task. In particular, this is due to the difficulties in defining and understanding the baseline mechanisms underlying SD. “Sudden” death is commonly regarded as a synonym of “cardiac arrest due to ventricular fibrillation,” which is in turn considered to be a merely arrhythmic phenomenon occurring during apparent wellbeing, and without any precipitating cause other than an extrasystole or a sustained ventricular tachycardia. Cardiac arrest may also be the terminal event during refractory pulmonary edema and/or cardiogenic shock in a patient with end-stage heart failure, a pulmonary embolism in a patient with severe biventricular dysfunction, bradyarrhythmia due to advanced atrioventricular (AV) block, electrical asystole, ventricular fibrillation secondary to myocardial ischemia or infarction, or secondary to a noncardiac event such as a cerebro vascular accident or a ruptured aortic aneurysm. Pratt et al.[1] analyzed a population of 834 patients with an automatic implantable cardioverter defibrillator (ICD) implanted for ventricular tachycardia or sustained ventricular tachycardia. During follow-up 109 patients died (17 died “suddenly”). Autopsy findings revealed a nonarrhythmic cause (pulmonary embolism, ruptured aortic aneurysm, stroke, acute myocardial infarction) in 7/17 patients. Postmortem analysis of the ICD memory revealed ventricular tachyarrhythmias preceding death in only 7/17 patients.
- Subjects :
- Heart Failure
Sudden Death
medicine.medical_specialty
business.industry
Cardiogenic shock
medicine.medical_treatment
medicine.disease
Implantable cardioverter-defibrillator
Ventricular tachycardia
Sudden death
Internal medicine
Heart failure
Ventricular fibrillation
cardiovascular system
medicine
Cardiology
cardiovascular diseases
Myocardial infarction
Asystole
business
Subjects
Details
- ISBN :
- 978-88-470-0557-0
- ISBNs :
- 9788847005570
- Database :
- OpenAIRE
- Journal :
- Perioperative Critical Care Cardiology ISBN: 9788847005570
- Accession number :
- edsair.doi.dedup.....f511e961ad10970172e29ba2b464c030