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Review
. 2023 Sep 9;402(10405):883-936.
doi: 10.1016/S0140-6736(23)00875-9. Epub 2023 Aug 27.

The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action

Affiliations
Review

The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action

Eloi Marijon et al. Lancet. .

Abstract

Despite major advancements in cardiovascular medicine, sudden cardiac death (SCD) continues to be an enormous medical and societal challenge, claiming millions of lives every year. Efforts to prevent SCD are hampered by imperfect risk prediction and inadequate solutions to specifically address arrhythmogenesis. Although resuscitation strategies have witnessed substantial evolution, there is a need to strengthen the organisation of community interventions and emergency medical systems across varied locations and health-care structures. With all the technological and medical advances of the 21st century, the fact that survival from sudden cardiac arrest (SCA) remains lower than 10% in most parts of the world is unacceptable. Recognising this urgent need, the Lancet Commission on SCD was constituted, bringing together 30 international experts in varied disciplines. Consistent progress in tackling SCD will require a completely revamped approach to SCD prevention, with wide-sweeping policy changes that will empower the development of both governmental and community-based programmes to maximise survival from SCA, and to comprehensively attend to survivors and decedents' families after the event. International collaborative efforts that maximally leverage and connect the expertise of various research organisations will need to be prioritised to properly address identified gaps. The Commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment. The Commission provides a critical assessment of the current scientific efforts in the field, and puts forth key recommendations to challenge, activate, and intensify efforts by both the scientific and global community with new directions, research, and innovation to reduce the burden of SCD worldwide.

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Conflict of interest statement

Declaration of interests CMA declares grants from St Jude Medical Foundation and NIH–NHLBI; consulting fees from Medtronic, Illumina, and Novartis; payment or honoraria for lectures from Medtronic; and participation on a data safety monitoring board or advisory board for Medtronic, Element Science, and Boston Scientific. J-BLPDW declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Medtronic, Biotronik, Boston Scientific, and Abbott. MTB declares grants from the EU ESCAPE-NET project, funded by the EU's Horizon 2020 research and innovation programme under grant agreement 733381; and grants from European Foundation for the Study of Diabetes (for project Improvement of CVD risk stratification: an innovative method for optimal timing of ECG monitoring). LC declares grants from Grant Horizon 2020 (2016–22) ESCAPE-NET; ERA-CVD Empathy (2020–23) for the electromechanical presages of sudden cardiac death in the young: integrating imaging, modelling, and genetics for patient stratification; grants from AIFA (2020–23) for novel therapy for the long QT syndrome type 2 based on the mechanism of action of the disease-causing mutations; grants from EJP RD (European Joint Program on Rare Disesase) LQTS-NEXT (2020–23) to the next level of risk prediction in patients with long QT syndrome; grants from EJP RD Silence-LQTS (2021–24) for SGK1 inhibition as a novel therapeutic approach in long QT syndrome; and participation on a data safety monitoring board or advisory board for Bristol Myers Squibb. FF declares grants and support for attending meetings or travel from Novo Nordisk Foundation NNF19OC0055142. GH declares grants from European Commission (PROFID project public grant for the development of a risk stratification tool to predict SCD and to evaluate the risk predictor in a clinical trial; NCT04540289) and German Federal Joint Committee (G-BA; RESET CRT public grant for a clinical trial comparing CRT-D versus CRT-P). JI declares research support from National Health and Medical Research Council Australia, Heart Foundation Australia, and New South Wales Health. JJ declares grants from Academy of Finland, Finnish Foundation for Cardiovascular Research, and Sigrid Juselius Foundation; support for attending meetings and travel from AstraZeneca, Bayer, Boehringer Ingelheim, Pfizer, and Orion Pharma; and participation on a data safety monitoring board or advisory board for Novo Nordisk, Bayer, and Boehringer Ingelheim. EM declares research grants from Abbott, Biotronik, Boston Scientific, Medtronic, MicroPort, and Zoll; consulting fees from Medtronic, Boston Scientific, Zoll, and Abbott; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Medtronic, Boston Scientific, Zoll, and Abbott. MEHO declares other financial or non-financial interests from TIIM Healthcare and Global Healthcare SG. TMO declares participation on a data safety monitoring board for the COCA trial (a randomised controlled trial evaluating calcium during cardiac arrest). MP declares grants from St George's, University of London for research on cardiac risk in the young and consulting fees from Bristol Myers Squibb. CS declares being an employee at American Heart Association. H-FT declares research grants from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Medtronic, Novartis, Pfizer, and Sanofi; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Amgen, AstraZeneca, Boehringer Ingelheim, Boston Scientific, Daiichi Sankyo, Medtronic, Pfizer, and Sanofi; and support for attending meetings and travel from Boehringer Ingelheim. ZT declares grants or contracts from National Institutes of Health (NIH) and National Heart, Lung, and Blood Institute (NHLBI; NIH/NHLBI R01 HL 102090, NIH/NHLBI R01 HL 126555, NIH/NHLBI R01 HL 147035, and NIH/NHLBI R01 HL 157247), NIH and National Institute of Allergy and Infectious Diseases (NIAID; NIH/NIAID P01 AI 169606), and Centers for Disease Control and Prevention (6 NU38DP000019-01-01 and 1 NU38DP000019-01-00). All other authors declare no competing interests.

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