Goldberger J J, Neelagaru S
Division of Cardiology, Department of Medicine, Northwestern University, Chicago, Illinois, USA.
Expert Opin Investig Drugs. 2000 Nov;9(11):2543-54. doi: 10.1517/13543784.9.11.2543.
Sudden cardiac death is characterised by the unexpected death of a patient who has been clinically stable. It is frequently due to the development of ventricular tachyarrhythmias. With appropriate treatment, patients can be appropriately resuscitated. Clinically, it is essential to develop treatment strategies to prevent such an episode, as most patients do not survive out-of-hospital cardiac arrest. beta-Blockers are an effective pharmacological therapy in patients following myocardial infarction and in those with congestive heart failure. They may also be effective in other types of heart disease. Anti-arrhythmic agents are not useful as prophylactic drug therapy for reducing mortality in patients at risk for sudden cardiac death. Amiodarone is a notable exception, which may have some benefit, particularly in some subgroups. The implantable cardioverter-defibrillator has emerged as the most effective therapy for preventing sudden cardiac death in high-risk patients. Further work is required to enhance the characterisation of high-risk patients. Genetic analyses in patients with cardiovascular disorders may also identify new approaches to the prevention of sudden cardiac death.
心脏性猝死的特征是临床病情稳定的患者意外死亡。其常常是由于室性快速性心律失常的发生。经过适当治疗，患者能够得到恰当复苏。临床上，制定预防此类发作的治疗策略至关重要，因为大多数患者无法从院外心脏骤停中存活。β受体阻滞剂对心肌梗死后患者和充血性心力衰竭患者是一种有效的药物治疗。它们在其他类型的心脏病中可能也有效。抗心律失常药物作为预防性药物治疗对于降低心脏性猝死风险患者的死亡率并无用处。胺碘酮是一个显著例外，它可能有一些益处，特别是在某些亚组中。植入式心律转复除颤器已成为预防高危患者心脏性猝死的最有效治疗方法。需要进一步开展工作以强化对高危患者的特征描述。对心血管疾病患者进行基因分析也可能识别出预防心脏性猝死的新方法。
