Heart Disease: Sudden Cardiac Death (cont.)

The ICD may be used in patients who have survived sudden cardiac arrest and need their heart rhythms constantly monitored. It may also be combined with a pacemaker to treat other underlying irregular heart rhythms.

Interventional procedures or surgery: For patients with coronary artery disease, an interventional procedure such as angioplasty (blood vessel repair) or bypass surgery may be needed to improve blood flow to the heart muscle and reduce the risk of SCD. For patients with other conditions, such as hypertrophic cardiomyopathy or congenital heart defects, an interventional procedure or surgery may be needed to correct the problem. Other procedures may be used to treat abnormal heart rhythms, including electrical cardioversion and catheter ablation.

When a heart attack occurs in the left ventricle (left lower pumping chamber of the heart), a scar forms. The scarred tissue may increase the risk of ventricular tachycardia. The electrophysiologist (doctor specializing in electrical disorders of the heart) can determine the exact area causing the arrhythmia. The electrophysiologist, working with your surgeon, may combine ablation (the use of high-energy electrical energy to "disconnect" abnormal electrical pathways within the heart) with left ventricular reconstruction surgery (surgical removal of the infarcted or dead area of heart tissue).

Educate your family members: If you are at risk for SCD, talk to your family members so they understand your condition and the importance of seeking immediate care in the event of an emergency. Family members and friends of those at risk for SCD should know how to perform CPR.

Can Sudden Cardiac Death Be Treated?

Yes, sudden cardiac arrest can be treated and reversed, but emergency action must take place immediately. Survival can be as high as 90% if treatment is initiated within the first minutes after sudden cardiac arrest. The rate decreases by about 10% each minute longer it takes to initiate therapy. Those who survive have a good long-term outlook.

What Do I Do if I Witness Sudden Cardiac Arrest?

If you witness someone experiencing sudden cardiac arrest, dial 911 or your local emergency personnel immediately and initiate CPR. If done properly, CPR can save a person's life, as the procedure keeps blood and oxygen circulating through the body until help arrives.

If there is an AED available, the best chance of rescuing the person includes defibrillation with that device. The shorter the time until defibrillation, the greater the chance the person will survive. It is CPR plus defibrillation that saves a person.

After successful defibrillation, most people require hospital care to treat and prevent future cardiac problems.

Sudden cardiac death and athletes

SCD occurs rarely in athletes, but when it does happen, it often affects us with shock and disbelief.

Cause: Most cases of SCD are related to undetected cardiovascular disease. In the younger population, SCD is often due to congenital heart defects, while in older athletes (35 years and older), the cause is more often related to coronary artery disease.

Prevalence: SCD in athletes is rare, but media coverage often makes it seem like it is more prevalent. In the younger population, most SCD occurs while playing team sports. It occurs in about one in 100,000 to one in 300,000 athletes, and more often in males. In older athletes (35 years and older), SCD occurs more often while running or jogging, and in about one in 15,000 joggers and one in 50,000 marathon runners.

Screening: The American Heart Association recommends cardiovascular screening for high school and collegiate athletes and should include a complete and careful evaluation of the athlete's personal and family history and a physical exam. Screening should be repeated every two years, with a history obtained every year. Men aged 40 and older and women aged 50 and older should also have a thorough examination and an exercise stress test and receive education about cardiac risk factors and symptoms. If heart problems are identified or suspected, the individual should be referred to a cardiologist for further evaluation and treatment guidelines before participating in sports.

For More Information

Sudden Arrhythmia Death Syndromes Foundation
A nonprofit organization, established to help prevent sudden and unexpected cardiac death in children and young adults.
508 E South Temple Ste. 20,
Salt Lake City, UT 84102
1-800-786-7723
www.sads.org

Heart Rhythm Society
1400 K St., NW, Suite 500,
Washington D.C. 20005
(202) 464-3400
www.HRSpatients.org

CPR Information: For more information about CPR, please contact your local chapter of the American Red Cross or the American Heart Association. Or ask your doctor for more information.

Reviewed by The Cleveland Clinic Heart Center (2005).

SOURCE: The American Heart Association

Reviewed by David W. Stein, MD on December 01, 2006

Edited by Tracy C. Shuman, MD on October 01, 2005

Portions of this page © The Cleveland Clinic 2000-2005



Last Editorial Review: 9/25/2007