The Primary Prevention of Sudden Death in Patients with Coronary Artery Disease
Authors: Michael J. Domanski
Journal: Annals of Internal Medicine (1993)

Editorials15 December 1993The Primary Prevention of Sudden Death in Patients with Coronary Artery DiseaseMichael J. Domanski, MD and Alfred E. Buxton, MDMichael J. Domanski, MDNational Heart, Lung, and Blood Institute, Bethesda, MD 20892. Temple University School of Medicine, Philadelphia, PA 19140.Search for more papers by this author and Alfred E. Buxton, MDNational Heart, Lung, and Blood Institute, Bethesda, MD 20892. Temple University School of Medicine, Philadelphia, PA 19140.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-12-199312150-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail About 300 000 people suffer sudden cardiac arrest in the United States each year [1]. In those who recover, the risk for recurrent cardiac arrest approaches 30% during the next 2 years when the initial arrest was not associated with acute myocardial infarction [2, 3]. This risk has increased interest in secondary prevention, that is, in preventing subsequent cardiac arrest. Unfortunately, only a few persons who have an out-of-hospital cardiac arrest survive to hospital discharge [3, 4]. Focused attempts at resuscitation by community-based emergency teams result in survival rates of 14% to 16% of cardiac arrests [3, 4]. Because of ...References1. Myerburg R, Castellanos A. Cardiac arrest and sudden cardiac death. In: Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine. 4th ed. Philadelphia: W.B. Saunders; 1992:756-89. Google Scholar2. Schaffer W, Cobb LA. Recurrent ventricular fibrillation and modes of death in survivors of out-of-hospital ventricular fibrillation. N Engl J Med. 1975; 293:259-62. Google Scholar3. Baum RS, Alvarez H 3d, Cobb LA. Survival after resuscitation from out-of-hospital ventricular fibrillation. Circulation. 1974; 50:1231-5. Google Scholar4. Liberthson RR, Nagel EL, Hirschman JC, Nussenfield SR. Prehospital ventricular fibrillation. Prognosis and follow-up course. N Engl J Med. 1974; 291:317-21. Google Scholar5. Myerburg RJ, Kessler KM, Castellanos A. Epidemiology, transient risk, and intervention assessment for sudden cardiac death. Ann Intern Med. 1993; 119:1187-1197. Google Scholar6. Bigger JT Jr. Relation between left ventricular dysfunction and ventricular arrhythmias after myocardial infarction. Am J Cardiol. 1986; 57:8B-14B. Google Scholar7. Morady F, Scheinman MM, Hess DS, Sung RJ, Shen E, Shapiro W. Electrophysiologic testing in the management of survivors of out-of-hospital cardiac arrest. Am J Cardiol. 1983; 51:85-9. Google Scholar8. Skale BT, Miles WM, Herger JJ, Zipes DP, Prystowsky EN. Survivors of cardiac arrest: prevention of recurrence by drug therapy as predicted by electrophysiologic testing or electrocardiographic monitoring. Am J Cardiol. 1986; 57:113-9. Google Scholar9. Wilber DJ, Garan H, Finkelstein D, Kelly E, Newell J, McGovern B, et al. Out-of-hospital cardiac arrest. Use of electrophysiologic testing in prediction of long-term outcome. N Engl J Med. 1988; 318: 19-24. Google Scholar10. Farrel TG, Bashir Y, Cripps T, Malik M, Poloniecki J, Bennett ED, et al. Risk stratification for arrhythmic events in postinfarction patients based on heart rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram. J Am Coll Cardiol. 1991; 18:687-97. Google Scholar11. Kuchar D, Thorburn CW, Sammel NL. Prediction of serious arrhythmic events after myocardial infarction: signal-averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol. 1987; 9:531-8. Google Scholar12. Breithart G, Borgrefe M, Martinez-Rubio A, Podczeck A. Signal-averaging. Prog Cardiol. 1988; 1/2:257. Google Scholar13. Simson M. Signal-averaged electrocardiography: methods and clinical applications. In: Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine 3d ed. Philadelphia: W.B. Saunders; update no. 7; 1990. Google Scholar14. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991; 324:781-8. Google Scholar15. The Cardiac Arrhythmia Suppression Trial II Investigators. Effect of the antiarrhythmic agent moriciaine on survival after myocardial infarction. N Engl J Med. 1992; 327:227-33. Google Scholar16. The CASCADE Investigators. Randomized antiarrhythmic drug therapy in survivors of cardiac arrest. Am J Cardiol. 1993; 72:280-7. Google Scholar17. Mirowski M, Reid PR, Mower MM, Watkins L, Gott VL, Schauble JF, et al. Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N Engl J Med. 1980; 303:322-4. Google Scholar18. Tchou PJ, Kadri N, Anderson J, Caceres JA, Jazayeri M, Akhtar M. Automatic implantable cardioverter defibrillators and survival of patients with left ventricular dysfunction and malignant ventricular arrhythmias. Ann Intern Med. 1988; 109:529-34. Google Scholar19. Maloney J, Masterson M, Khoury D, Trohman R, Wilkoff B, Simmons T, et al. Clinical performance of the implantable cardioverter- defibrillator: electrocardiographic documentation of 101 spontaneous discharges. Pace. 1991; 14(Suppl 2):280-5. Google Scholar20. Saksena S, Poczobutt-Johanos M, Castle L, Fogoros RN, Alpert BL, Kron J, et al. Long-term multicenter experience with a second-generation implantable pacemaker-defibrillator. The Guardian Multicenter Investigator Group. J Am Coll Cardiol. 1992; 19:490-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: National Heart, Lung, and Blood Institute, Bethesda, MD 20892. Temple University School of Medicine, Philadelphia, PA 19140.Corresponding Author: Michael J. Domanski, MD, Clinical Trials Branch, National Heart, Lung, and Blood Institute, Bethesda, MD 20892. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSudden Cardiac Death: Epidemiology, Transient Risk, and Intervention Assessment Robert J. Myerburg , Kenneth M. Kessler , and Agustin Castellanos Metrics Cited ByKardiovaskuläre NotfälleImplantable cardioverter-defibrillator dysfunction after coronary artery bypass graftingSudden Cardiac Death Prevention: Antiarrhythmic Drugs and the Implantable Cardioverter-Defibrillator 15 December 1993Volume 119, Issue 12Page: 1218-1220KeywordsDrugsElectrocardiographyHeartImplantable cardioverter defibrillatorsMedical risk factorsMortalityMyocardial infarctionSudden cardiac deathTachycardiaVentricular tachycardia Issue Published: 15 December 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...