Sudden cardiac death: Difference between revisions
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===Class IIb=== | ===Class IIb=== | ||
1. [[ICD therapy]] may be considered in patients with nonischemic heart disease who have an LVEF of less than or equal to 35% and who are in NYHA functional Class I. (Level of Evidence: C) | 1. [[ICD therapy]] may be considered in patients with [[nonischemic heart disease]] who have an [[LVEF]] of less than or equal to 35% and who are in NYHA functional Class I. (Level of Evidence: C) | ||
2. [[ICD therapy]] may be considered for patients with long-QT syndrome and risk factors for SCD. (Level of Evidence: B) | 2. [[ICD therapy]] may be considered for patients with [[long-QT syndrome]] and risk factors for [[SCD]]. (Level of Evidence: B) | ||
3. [[ICD therapy]] may be considered in patients with syncope and advanced structural heart disease in whom thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C) | 3. [[ICD therapy]] may be considered in patients with [[syncope]] and advanced structural heart disease in whom thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C) | ||
4. [[ICD therapy]] may be considered in patients with a familial cardiomyopathy associated with sudden death. (Level of Evidence: C) | 4. [[ICD therapy]] may be considered in patients with a [[familial cardiomyopathy]] associated with sudden death. (Level of Evidence: C) | ||
5. [[ICD therapy]] may be considered in patients with LV noncompaction. (Level of Evidence: C) | 5. [[ICD therapy]] may be considered in patients with [[LV noncompaction]]. (Level of Evidence: C) | ||
===Class III=== | ===Class III=== | ||
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1. [[ICD therapy]] is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet [[ICD implantation]] criteria specified in the Class I, IIa, and IIb recommendations above. (Level of Evidence: C) | 1. [[ICD therapy]] is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet [[ICD implantation]] criteria specified in the Class I, IIa, and IIb recommendations above. (Level of Evidence: C) | ||
2. [[ICD therapy]] is not indicated for patients with incessant VT or VF. (Level of Evidence: C) | 2. [[ICD therapy]] is not indicated for patients with incessant [[VT]] or [[VF]]. (Level of Evidence: C) | ||
3. [[ICD therapy]] is not indicated in patients with significant psychiatric | 3. [[ICD therapy]] is not indicated in patients with significant [[psychiatric illness]]es that may be aggravated by device implantation or that may preclude systematic follow-up. (Level of Evidence: C) | ||
4. [[ICD therapy]] is not indicated for NYHA Class IV patients with drug-refractory congestive heart failure who are not candidates for cardiac transplantation or CRT-D. (Level of Evidence: C) | 4. [[ICD therapy]] is not indicated for NYHA Class IV patients with [[drug-refractory congestive heart failure]] who are not candidates for [[cardiac transplantation]] or [[CRT-D]]. (Level of Evidence: C) | ||
5. [[ICD therapy]] is not indicated for syncope of undetermined cause in a patient without inducible ventricular tachyarrhythmias and without structural heart disease. (Level of Evidence: C) | 5. [[ICD therapy]] is not indicated for [[syncope]] of undetermined cause in a patient without [[inducible ventricular tachyarrhythmias]] and without structural [[heart disease]]. (Level of Evidence: C) | ||
6. [[ICD therapy]] is not indicated when VF or VT is amenable to surgical or catheter ablation (e.g., atrial arrhythmias associated with the Wolff-Parkinson-White syndrome, RV or LV outflow tract VT, idiopathic VT, or fascicular VT in the absence of structural heart disease). (Level of Evidence: C) | 6. [[ICD therapy]] is not indicated when [[VF]] or [[VT]] is amenable to surgical or catheter ablation (e.g., [[atrial arrhythmias]] associated with the [[Wolff-Parkinson-White syndrome]], [[RV]] or [[LV]] [[outflow tract VT]], [[idiopathic VT]], or [[fascicular VT]] in the absence of structural [[heart disease]]). (Level of Evidence: C) | ||
7. [[ICD therapy]] is not indicated for patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (e.g., electrolyte imbalance, drugs, or trauma). (Level of Evidence: B)}} | 7. [[ICD therapy]] is not indicated for patients with [[ventricular tachyarrhythmias]] due to a completely reversible disorder in the absence of structural [[heart disease]] (e.g., [[electrolyte imbalance]], [[drugs]], or [[trauma]]). (Level of Evidence: B)}} | ||
===ACC / AHA Guidelines- Recommendations for Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease (DO NOT EDIT) <ref name="pmid18483207">{{cite journal |author=Epstein AE, DiMarco JP, Ellenbogen KA, ''et al'' |title=ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons |journal=Circulation |volume=117 |issue=21 |pages=e350-408 |year=2008 |month=May |pmid=18483207 |doi:10.1161/CIRCUALTIONAHA.108.189742 |url=}}</ref>=== | ===ACC / AHA Guidelines- Recommendations for Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease (DO NOT EDIT) <ref name="pmid18483207">{{cite journal |author=Epstein AE, DiMarco JP, Ellenbogen KA, ''et al'' |title=ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons |journal=Circulation |volume=117 |issue=21 |pages=e350-408 |year=2008 |month=May |pmid=18483207 |doi:10.1161/CIRCUALTIONAHA.108.189742 |url=}}</ref>=== |
Revision as of 15:27, 26 May 2009
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
The term sudden cardiac death refers to natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms.[1] Other forms of sudden death may be noncardiac in origin. Examples of this include respiratory arrest (such as due to airway obstruction, which may be seen in cases of choking or asphyxiation), toxicity or poisoning, anaphylaxis, or trauma.[2]
It is important to make a distinction between this term and the related term cardiac arrest, which refers to cessation of cardiac pump function which may be reversible (i.e., may not be fatal). The phrase Sudden Cardiac Death is a public health concept incorporating the features of natural, rapid, and unexpected. It does not specifically refer to the mechanism or cause of death. Although the most frequent underlying cause of Sudden Cardiac Death is Coronary Artery Disease, other categories of causes are listed below.
Prevention
ACC / AHA Guidelines- Recommendations for Implantable Cardioverter Defibrillators (DO NOT EDIT) [3]
“ |
Class I1. ICD therapy is indicated in patients who are survivors of cardiac arrest due to VF or hemodynamically unstable sustained VT after evaluation to define the cause of the event and to exclude any completely reversible causes. (Level of Evidence: A) 2. ICD therapy is indicated in patients with structural heart disease and spontaneous sustained VT, whether hemodynamically stable or unstable. (Level of Evidence: B) 3. ICD therapy is indicated in patients with syncope of undetermined origin with clinically relevant, hemodynamically significant sustained VT or VF induced at electrophysiological study. (Level of Evidence: B) 4. ICD therapy is indicated in patients with LVEF less than 35% due to prior MI who are at least 40 days post-MI and are in NYHA functional Class II or III. (Level of Evidence: A) 5. ICD therapy is indicated in patients with nonischemic DCM who have an LVEF less than or equal to 35% and who are in NYHA functional Class II or III. (Level of Evidence: B) 6. ICD therapy is indicated in patients with LV dysfunction due to prior MI who are at least 40 days post-MI, have an LVEF less than 30%, and are in NYHA functional Class I. (Level of Evidence: A) 7. ICD therapy is indicated in patients with nonsustained VT due to prior MI, LVEF less than 40%, and inducible VF or sustained VT at electrophysiological study. (Level of Evidence: B) Class IIa1. ICD implantation is reasonable for patients with unexplained syncope, significant LV dysfunction, and nonischemic DCM. (Level of Evidence: C) 2. ICD implantation is reasonable for patients with sustained VT and normal or near-normal ventricular function. (Level of Evidence: C) 3. ICD implantation is reasonable for patients with HCM who have 1 or more major{dagger} risk factors for SCD. (Level of Evidence: C) 4. ICD implantation is reasonable for the prevention of SCD in patients with ARVD/C who have 1 or more risk factors for SCD. (Level of Evidence: C) 5. ICD implantation is reasonable to reduce SCD in patients with long-QT syndrome who are experiencing syncope and/or VT while receiving beta blockers. (Level of Evidence: B) 6. ICD implantation is reasonable for non hospitalized patients awaiting transplantation. (Level of Evidence: C) 7. ICD implantation is reasonable for patients with Brugada syndrome who have had syncope. (Level of Evidence: C) 8. ICD implantation is reasonable for patients with Brugada syndrome who have documented VT that has not resulted in cardiac arrest. (Level of Evidence: C) 9. ICD implantation is reasonable for patients with catecholaminergic polymorphic VT who have syncope and/or documented sustained VT while receiving beta blockers. (Level of Evidence: C) 10. ICD implantation is reasonable for patients with cardiac sarcoidosis, giant cell myocarditis, or Chagas disease. (Level of Evidence: C) Class IIb1. ICD therapy may be considered in patients with nonischemic heart disease who have an LVEF of less than or equal to 35% and who are in NYHA functional Class I. (Level of Evidence: C) 2. ICD therapy may be considered for patients with long-QT syndrome and risk factors for SCD. (Level of Evidence: B) 3. ICD therapy may be considered in patients with syncope and advanced structural heart disease in whom thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C) 4. ICD therapy may be considered in patients with a familial cardiomyopathy associated with sudden death. (Level of Evidence: C) 5. ICD therapy may be considered in patients with LV noncompaction. (Level of Evidence: C) Class III1. ICD therapy is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet ICD implantation criteria specified in the Class I, IIa, and IIb recommendations above. (Level of Evidence: C) 2. ICD therapy is not indicated for patients with incessant VT or VF. (Level of Evidence: C) 3. ICD therapy is not indicated in patients with significant psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up. (Level of Evidence: C) 4. ICD therapy is not indicated for NYHA Class IV patients with drug-refractory congestive heart failure who are not candidates for cardiac transplantation or CRT-D. (Level of Evidence: C) 5. ICD therapy is not indicated for syncope of undetermined cause in a patient without inducible ventricular tachyarrhythmias and without structural heart disease. (Level of Evidence: C) 6. ICD therapy is not indicated when VF or VT is amenable to surgical or catheter ablation (e.g., atrial arrhythmias associated with the Wolff-Parkinson-White syndrome, RV or LV outflow tract VT, idiopathic VT, or fascicular VT in the absence of structural heart disease). (Level of Evidence: C) 7. ICD therapy is not indicated for patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (e.g., electrolyte imbalance, drugs, or trauma). (Level of Evidence: B) |
” |
ACC / AHA Guidelines- Recommendations for Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease (DO NOT EDIT) [3]
“ |
Class I1. ICD implantation is indicated in the survivor of cardiac arrest after evaluation to define the cause of the event and to exclude any reversible causes. (Level of Evidence: B) 2. ICD implantation is indicated for patients with symptomatic sustained VT in association with congenital heart disease who have undergone hemodynamic and electrophysiological evaluation. Catheter ablation or surgical repair may offer possible alternatives in carefully selected patients. (Level of Evidence: C) Class IIa1. ICD implantation is reasonable for patients with congenital heart disease with recurrent syncope of undetermined origin in the presence of either ventricular dysfunction or inducible ventricular arrhythmias at electrophysiological study. (Level of Evidence: B) Class IIb1. ICD implantation may be considered for patients with recurrent syncope associated with complex congenital heart disease and advanced systemic ventricular dysfunction when thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C) Class III1. All Class III recommendations found in Section 3, "Indications for Implantable Cardioverter-Defibrillator Therapy," apply to pediatric patients and patients with congenital heart disease, and ICD implantation is not indicated in these patient populations. (Level of Evidence: C) |
” |
Sources
- ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons [3]
- ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines) [4]
- ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary--a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation) [5]
Complete Differential Diagnosis for Sudden Cardiac Death
- Acute Cardiac tamponade
- After ST Elevation Myocardial Infarction
- Aortic dissection
- Aortic stenosis
- Apoplexy
- Arrhythmogenic right ventricular dysplasia
- Arteritis
- Asphyxia
- Cardiomyopathy including:
Myocardial diseases and heart failure, including
- Commotio cordis
- Complete atrioventricular block
- Congenital heart disease
- Congestive heart failure
- Coronary artery disease
- Drugs
- Hypoxia
- Hypercapnia
- Hypercalcemia
- Hyperkalemia
- Hypokalemia
- Mitral valve prolapse
- Myocardial Disease
- Pickwickian Syndrome
- Primary electrophysiological abnormalities, such as
- Prolonged Q-T Interval Syndrome
- Pulmonary embolism
- Rupture of the papillary muscles
- Shock
- Status asthmaticus
- Stokes-Adams Syndrome
- Sudden Infant Death Syndrome
- Tension pneumothorax
- Thyrotoxicosis
- Toxic/metabolic disturbances
- Valvular Heart Disease
- Ventricular rupture
- Wolf-Parkinson-White syndrome
References
- ↑ Myerburg, Robert J. "Cardiac Arrest and Sudden Cardiac Death" in Heart Disease: A Textbook of Cardiovascular Medicine, 7th edition. Philadelphia: WB Saunders, 2005.
- ↑ Sudden Unexpected Death: Causes and Contributing Factors on poptop.hypermart.net.
- ↑ 3.0 3.1 3.2 Epstein AE, DiMarco JP, Ellenbogen KA; et al. (2008). "ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons". Circulation. 117 (21): e350–408. PMID 18483207. Text "doi:10.1161/CIRCUALTIONAHA.108.189742 " ignored (help); Unknown parameter
|month=
ignored (help) - ↑ Gregoratos G, Abrams J, Epstein AE; et al. (2002). "ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines)". Circulation. 106 (16): 2145–61. PMID 12379588. Text "doi:10.1161/01.CIR.0000035996.46455.09 " ignored (help); Unknown parameter
|month=
ignored (help) - ↑ Gregoratos G, Cheitlin MD, Conill A; et al. (1998). "ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary--a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation)". Circulation. 97 (13): 1325–35. PMID 9570207. Unknown parameter
|month=
ignored (help)
External links
- Information from the Stanford Hypertrophic Cardiomyopathy Center
- Arrhythmia Alliance Sudden Cardiac Arrest Page
Additional resources
- ECGpedia: Course for interpretation of ECG
- The whole ECG - A basic ECG primer
- 12-lead ECG library
- Simulation tool to demonstrate and study the relation between the electric activity of the heart and the ECG
- ECG information from Children's Hospital Heart Center, Seattle
- ECG Challenge from the ACC D2B Initiative
- National Heart, Lung, and Blood Institute, Diseases and Conditions Index
- A history of electrocardiography
- EKG Interpretations in infants and children