Author/Editor		Kenda, Miran Frančišek
Title		Sudden death in congestive heart failure
Type		članek
Source		In: Pajer Z, Štiblar-Martinčič D, editors. International symposium on cardiovascular diseases. Proceedings of the 29th memorial meeting devoted to prof. dr. Janez Plečnik; 1998 Dec 3-5; Ljubljana. Ljubljana: Medical faculty, Institute of histology and embryology,
Publication year		1998
Volume		str. 223-9
Language		eng
Abstract		Patients with heart failure (HF) are at increased risk of sudden cardiac death (SCD). This fact is not only a medical but also a great socio-economic problem. Despite of the significant progress in treatment and prevention of cardiovascular diseases, the incidence and prevalence of HF have been increasing especially in elderly. The most common cause od chronic HF as well as SCD is coronary artery disease (CAD) in about 70% of pts. The most frequent cause of SCD in HF are malignant ventricular arrhythmias, especilly ventricular tachycardia (VT) caused by acute coronary event coupled with previous myocardial damage and pump dysfunction. The degree of functional impairment classified by NYHA classification is the simplest variable to predict overall mortality. Left ventricular dysfunction in term of ejection fraction has been established as a major predictor ofoutcome in studies evaluating CAD, secondary prevention of SCD as well as in multiple HF studies. Neurohormonal activity has also been related with the prognosis. The signal averaged ECG may have alue in predicting SCD in post-MI patients. Heart rate variability (HRV) is reduced in patients with congestive HF and could be a useful predictor of death. Electrophysiologic studies have identified patients at higher risk for SCD in CAD group. Unfortunately, there are no until now undisputedly accepted markers to identify the pts with HF who are most prone to die suddenly. Concerning therapeutic strategies of HF to prevent SCD, data about ACE-inhibitors, beta-blockers and amiodarone are well documented; ACE-inhibitors for preventing the progression of HF and CAD, beta-blockers with relief of ischemia, reduction of heart rate and maintenance of favourable autonomic balance, and amiodarone with its unique complex antiarhythmic action.(Abstract truncated at 2000 characters)
Descriptors		HEART FAILURE, CONGESTIVE DEATH, SUDDEN, CARDIAC CAUSE OF DEATH ARRHYTHMIA ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ADRENERGIC BETA-ANTAGONISTS AMIODARONE DEFIBRILLATORS, IMPLANTABLE