Sudden Cardiac Death [antikvár]

PREFACEOnce every minute a sudden cardiac death occurs in the United States. It is the most common cause of death in people 20-65 years old and the most important public health problem in the industrialized world. Prevention of sudden cardiac death will depend on better understanding of the pathophysiologic mechanisms underlying it, its natural history in various groups of people, advances in models to detect and evaluate high-risk persons, and development of medical, mechanical, and surgical approaches for treating high-risk individuals. Sudden Cardiac-Death is a collection of up-to-date information available on this topic.The first four chapters present definitions, general clinical features, risk factors, and natural history in both pediatric and adult populations. While better methods of cardiopulmonary resuscitation and mobile coronary care units have enhanced survival, it is clear that primary prevention of sudden cardiac death will have a far greater impact on survival. Therefore, it becomes critical to identify and treat individuals. Identification of people at high risk by exercise testing, Holter monitoring, and electrophysiology are discussed in Chapters 5 through 8. Medical therapy to prevent sudden cardiac death has had a major advance in the last few years. Greater understanding of the electropharmacology and pharmacodynamics of antiarrhythmic drugs is an extremely important area. This avenue of treatment is comprehensively discussed in Chapters 9 through 13.Chapter 14 covers the current status of modifiable risk factors. The potential use of mechanical devices (e.g., synchronized, low-energy, transvenous cardioversion) is presented in Chapter 15 as an important development for prevention of sudden cardiac death. While these devices are still in a primarily investigative phase, their use, particularly when adjunctive to pharmacological control, brings great promise in the control of ventricular tachyarrhythmias, which prove to be the acute mechanism of sudden cardiac death in over 80 percent of patients. The role of cardiac surgery for treatment of ventricular arrhythmias, discussed in Chapter 16, provides another avenue to control these few patients with serious ventricular arrhythmias that modern drugs and mechanical devices are unable to effectively manage.Sadden Cardiac Death will present our current state of knowledge in this area and will provoke questions for further study.