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Review
. 2019 Oct;29(7):394-400.
doi: 10.1016/j.tcm.2018.11.002. Epub 2018 Nov 6.

Update on prevention and treatment of sudden cardiac arrest

Yuliya Krokhaleva  1 , Marmar Vaseghi  2
Affiliations
Review

Update on prevention and treatment of sudden cardiac arrest

Yuliya Krokhaleva et al. Trends Cardiovasc Med. 2019 Oct.

Abstract

Sudden cardiac arrest is the leading cause of cardiovascular mortality, posing a substantial public health burden. The incidence and epidemiology of sudden death are a function of age, with primary arrhythmia syndromes and inherited cardiomyopathies representing the predominant causes in younger patients, while coronary artery disease being the leading etiology in those who are 35 years of age and older. Internal cardioverter defibrillators remain the mainstay of primary and secondary prevention of sudden cardiac arrest. In the acute phase, cardiac chain of survival, early reperfusion, and therapeutic hypothermia are the key steps in improving outcomes. In the chronic settings, ventricular tachycardia ablation has been shown to improve patients' quality of life by reducing frequency of defibrillator shocks. Moreover, recent studies have suggested that it may increase survival. Neuromodulation represents a novel therapeutic modality that has a great potential for improving treatment of ventricular arrhythmias.

Keywords: Ablation; Cardiac arrest; Neuromodulation; Sudden cardiac death; Ventricular arrhythmia; Ventricular tachycardia.

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Figures

Figure 1.
Figure 1.
Management of acute sudden cardiac arrest includes rapid resuscitation and hypothermia protocol. SCA = sudden cardiac arrest.
Figure 2.
Figure 2.
Ventricular Tachycardia Ablation-Approach and Outcomes. The approach to ablation as well as the outcomes of VT ablation are dependent on the presenting myocardial substrate and genetic abnormality. ICD – internal cardioverter defibrillator; PVC – premature ventricular complex; VF – ventricular fibrillation; VT – ventricular tachycardia
Figure 3.
Figure 3.
Strategies for neuraxial modulation of ventricular tachyarrhythmias include methods to increase parasympathetic tone and decrease sympathetic activation. CBS – carotid body stimulation; CSD – cardiac sympathetic denervation; RND – renal denervation; SCS – spinal cord stimulation; SGB – stellate ganglion blockade; TEA – thoracic epidural anesthesia; VNS vagal nerve stimulation
See this image and copyright information in PMC

Comment in

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