Sudden death: managing the patient who survives

Transient Correctable Not transient nor correctable Ventricular fibrillation Sustained ventricular tachycardia Bradycardia Electromechanical dissociation Temporary monitoring Ablation Revascularisation Pacemaker ICD ICD, implantable cardioverter-defibrillator. Since the majority of patients have either structural heart disease or a primary electrical disease that can be arrhythmogenic, we will briefly review them ( box 1 ). Box 1 Main causes of sudden cardiac death Metabolic disturbances Primary structural disease Coronary artery disease Non-ischaemic cardiomyopathy Non-ischaemic dilated cardiomyopathy Hypertrophic cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy Primary electrophysiologic abnormalities Long QT syndrome Short QT syndrome Brugada syndrome Catecholaminergic polymorphic ventricular tachycardia Idiopathic ventricular fibrillation Cardiac causes of sudden death Primary structural disease Coronary artery disease Approximately 65-70% of SCDs are attributed to ischaemic heart disease, thus demonstrating that coronary artery disease (CAD) is the most frequent substrate underlying SCD.