Role of drugs and devices in patients at risk of sudden cardiac death.

摘要: The search for effective treatment preventing sudden cardiac death (SCD) initially started with anti-arrhythmic agents in high-risk patients, but the use of randomized controlled trials clearly led to conclusion that an approach based on is not useful, and sometimes potentially harmful (the risk arrhythmic was increased up 159% CAST study). Today SCD prevention includes considering both setting patients who have already presented a arrest or malignant ventricular tachyarrhythmias (secondary preventions SCD) much broader primary at variable degrees identifiable risk. For secondary SCD, implantable cardioverter defibrillation now standard care overall mortality may be reduced by 20-31%), agents, specifically amiodarone, only complementary role (for reducing device activations atrial fibrillation). defibrillators nowadays specific indications left dysfunction (often combination resynchronization therapy), where 23-54%. large number subjects some are identified as high series drugs could exert favorable effect (beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blocker statins, omega-3 fatty acids aldosterone antagonists), them evidence emerging, from subgroup analysis, possible capabilities.