Sudden cardiac death: epidemiology and temporal trends.

Sudden cardiac death (SCD) now accounts for more than half of all coronary heart disease deaths in the United States. The majority of cases are due to underlying coronary artery disease, and deaths from both coronary artery disease and SCD have declined markedly over the past several decades due to improved primary and secondary prevention and treatment strategies. This review examines the current statistics on the prevalence of SCD, and identifies those patients at greatest risk. It also discusses existing tests and treatments, including medication that results in neurohormonal antagonism, and devices such as the implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy with a defibrillator (CRT-D). Along with increased public awareness of SCD as a major health risk, physicians are advised to implement proven effective drug and devices that can improve survival.