Evéquoz D, Zuber M, Erne P
Division de cardiologie, Hôpital cantonal de Lucerne.
Praxis (Bern 1994). 1996 Feb 13;85(7):188-96.
Sudden cardiac death is defined as natural death due to cardiac causes, heralded by abrupt loss of consciousness within one hour after the onset of symptoms. The mechanisms are the following: 1. ventricular fibrillation, 2. ventricular tachycardia and flutter with subsequent ventricular fibrillation, 3. torsade de pointe, 4. bradyarrhythmias and asystolic arrest. White the main risk factor is the presence of coronary artery disease, any organic or functional disease of the heart can predispose for sudden cardiac death. To evaluate the risk of sudden cardiac death noninvasive (Holter, echocardiography, exercise test and signal averaged (ECG) and often invasive (electrophysiological study) tests are necessary. The therapy is based on drugs (mainly beta blockers and amiodarone), coronary revascularization, catheter ablation techniques and the implantation of a cardioverter defibrillator; the latter appears to be the most promising approach.
心源性猝死定义为因心脏原因导致的自然死亡，症状发作后1小时内突然意识丧失为其先兆。机制如下：1. 心室颤动；2. 室性心动过速和扑动伴随后的心室颤动；3. 尖端扭转型室速；4. 缓慢性心律失常和心脏停搏。虽然主要危险因素是冠状动脉疾病，但任何心脏的器质性或功能性疾病都可能引发心源性猝死。为评估心源性猝死风险，无创检查（动态心电图、超声心动图、运动试验和信号平均心电图）以及通常的有创检查（电生理研究）是必要的。治疗基于药物（主要是β受体阻滞剂和胺碘酮）、冠状动脉血运重建、导管消融技术以及植入心脏复律除颤器；后者似乎是最有前景的方法。
