Sudden cardiac death (SCD) is a sudden unexpected non-traumatic death due to cardiac causes occurring in a short time period (generally within 1 h of symptom onset). Incidence of SCD ranges between 0.1-0.2% per year in the adult population in Western industrialized nations.
SCD is often the first expression of coronary artery disease (CAD) and is responsible for approximately 50% of deaths from CAD. This syndrome is a major problem of contemporary medicine with a very poor prognosis.
The autor analyzes the epidemiology, causes, influence of the external environment, basic arrhythmogenic mechanisms and prognosis of SCD. Examination methods of this clinical condition are evaluated from the aspect of their application in the risk stratification of patients.
In addition to acute treatment of SCD the author focus attention in particular on an analysis of long-term therapeutic and prophylactic provisions to cope with this serious clinical condition. The basic therapeutic procedures include influencing of the arrhythmogenic substrate and modulating factors associated with the development of tachyarrhythmias by myocardial revascularization, the application of other surgical methods and non-antiarrhythmic pharmacotherapy.
Antiarrhythmic drugs and especially implantable cardioverter-defibrillators have irreplaceable position in therapy and prevention of haemodynamically important ventricular tachyarrhythmias.