Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research

doi:10.1016/S0008-6363(01)00260-7

Cardiovascular Research 2001 50(2):197-209; doi:10.1016/S0008-6363(01)00260-7
© 2001 by European Society of Cardiology

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Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research

Nona Sotoodehnia^a, Adam Zivin^a, Gust H Bardy^a and David S Siscovick^a^,b^,*

^aDepartment of Medicine, Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Suite 1360, MR9, Box 358080, Seattle, WA 98101, USA
^bDepartment of Epidemiology, University of Washington, Seattle, WA, USA

^* Corresponding author. Tel.: +1-206-287-2787; fax: +1-206-287-2662 dsisk{at}u.washington.edu

The reduction of mortality from sudden cardiac death (SCD) inthe community remains a challenge. Clinical—epidemiologicstudies have identified a range of factors that are associatedwith an increased risk of SCD. While of potential etiologicand prognostic importance, these factors have limited sensitivityand a low positive predictive value for SCD. On the other hand,clinical trials have suggested that a variety of interventions,including risk factor reduction, nutritional interventions,drug therapies, cardiac procedures, and new technologies, havethe potential to reduce mortality from SCD. In this review,we examine what is known about the epidemiology and clinicalapplication of interventions to reduce mortality from SCD; and,we consider the impact of both prevention and clinical interventionson mortality from SCD from a community perspective. There ismounting evidence that supports both public health and clinicalefforts to prevent the occurrence of SCD. There also is evidencesuggesting that new technologies, such as automated externaldefibrillators, have the potential to reduce case-fatality fromSCD. Further progress will depend on improved methods to identifypersons-at-risk, reduction of risk factors, and applicationof techniques — both simple and advanced — to improvesurvival in victims of SCD.

KEYWORDS Defibrillation; Epidemiology; Sudden death

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