Prevention of sudden cardiac death in patients up to 40 years of age

Česká verzia

Authors: J. Plášek
Authors place of work: Kardiovaskulární oddělení, FN Ostrava Lékařská fakulta OU, Ostrava
Published in the journal: Kardiol Rev Int Med 2018, 20(2): 96-103

Summary

In an unselected population it is difficult to identify patients at risk of sudden cardiac death, in selected subgroups of patients risk stratification might be feasible. In the group of young patients under 40 years of age, the following diagnosis should be considered as increased risk of sudden cardiac death: hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy and long QT syndrome. However, around 30% of sudden cardiac deaths remains unexplained. Specific population groups are athletes, where the “Seattle score” is a very useful tool in identifying patients at risk. Drug-induced long QT syndrome might portend significant risk of sudden cardiac death even in young patients. It is necessary to be familiar with particular risk medications, such as antipsychotics, azole antimycotics and macrolide antibiotics, and measure the QT interval properly. Screening for the risk of sudden cardiac death is helpful within the subgroup of athletes and people in occupational risk. For patients already identified with a higher risk of sudden cardiac death there are both pharmacological and non-pharmacological means of prevention. The strongest effect on the risk reduction of sudden cardiac death is achieved with betablockers, while implantation of transvenous or subcutaneous implantable cardioverter-defibrillator is the most common method of non-pharmacological prevention of sudden cardiac death, and catheter ablation can be performed in selected patients/disease.

Key words:
sudden cardiac death – hypertrophic cardiomyopathy – arrhythmogenic cardiomyopathy – long QT syndrome – subcutaneous implantable cardioverter-defibrillator

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