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Eur Heart J. 2014 Jul 1;35(25):1642-51. doi: 10.1093/eurheartj/ehu176. Epub 2014 May 5.

Risk stratification for sudden cardiac death: current status and challenges for the future.

Author information

1
Cardiovascular Research Center, Maastricht, The Netherlands.
2
IRCCS Istituto Auxologico Italiano, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy peter.schwartz@unipv.it.
3
Medtronic Bakken Research Center, Maastricht, The Netherlands.
4
Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
5
Division of Cardiology, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
6
Division of Clinical Electrophysiology, Department of Cardiology, J. W. Goethe University, Frankfurt, Germany.
7
Medical Research Center Oulu, University and University Hospital of Oulu, Oulu, Finland.
8
Department of Medicine I, University Hospital, Ludwig-Maximilians-University, Münich, Germany DZHK (German Centre for Cardiovascular Research), Partner Site Münich Heart Alliance, Münich, Germany.
9
Department of Cardiology, Fondazione 'Salvatore Maugeri', IRCCS, Istituto Scientifico di Montescano, Montescano, Pavia, Italy.
10
St Paul's Cardiac Electrophysiology, University of London and Imperial College, London, UK.
11
Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
12
Thoraxcentrum, Erasmus MC, Cardiology, Rotterdam, The Netherlands.
13
University of Gothenburg, Gothenburg, Sweden.
14
Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
15
University Medical Center Groningen, Groningen, The Netherlands.
16
Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands Princess Al Jawhara Albrahim Centre of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia.

Abstract

Sudden cardiac death (SCD) remains a daunting problem. It is a major public health issue for several reasons: from its prevalence (20% of total mortality in the industrialized world) to the devastating psycho-social impact on society and on the families of victims often still in their prime, and it represents a challenge for medicine, and especially for cardiology. This text summarizes the discussions and opinions of a group of investigators with a long-standing interest in this field. We addressed the occurrence of SCD in individuals apparently healthy, in patients with heart disease and mild or severe cardiac dysfunction, and in those with genetically based arrhythmic diseases. Recognizing the need for more accurate registries of the global and regional distribution of SCD in these different categories, we focused on the assessment of risk for SCD in these four groups, looking at the significance of alterations in cardiac function, of signs of electrical instability identified by ECG abnormalities or by autonomic tests, and of the progressive impact of genetic screening. Special attention was given to the identification of areas of research more or less likely to provide useful information, and thereby more or less suitable for the investment of time and of research funds.

KEYWORDS:

Autonomic nervous system; Cardiac function; Electrical instability; Genetics; Risk stratification; Sudden cardiac death

PMID:
24801071
PMCID:
PMC4076664
DOI:
10.1093/eurheartj/ehu176
[Indexed for MEDLINE]
Free PMC Article

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