Sudden cardiac death in heart failure.

Chronic heart failure (HF) and sudden cardiac death (SCD) present two major public health problems. The risk of death ranges from 10% to 50% annually in patients with HF, depending on the severity of disease. Approximately 50% of these deaths are sudden and presumed to be caused by dysrhythmias. This article defines the population at risk for SCD, explains the methods used for risk stratification, reviews current research on the pathophysiology of ventricular dysrhythmias in HF, and discusses pertinent clinical trials of therapeutic interventions on SCD in HF. The article also explores the effect of SCD on the patient and family with respect to counseling and education, resuscitative issues, and advanced directives.