Prevention of sudden cardiac death

Prevention of sudden cardiac death

Various components of a multifactorial approach for prevention of sudden cardiac death would include:

Modifying coronary risk factors at community level and individual level

By and large coronary artery disease is the most important cause of sudden cardiac death, though some cardiac channelopathies have a higher percentage risk of sudden cardiac death. This is because coronary artery disease is much more prevalent in the community than cardiac channelopathies. Hence controlling the modifiable coronary risk factors can go a long way in reducing the incidence of sudden cardiac death.

Community based training in cardiopulmonary resuscitation

Since majority of the sudden cardiac deaths are likely to occur at home or other public places, training in bystander initiated cardiopulmonary resuscitation will improve the chance of meaningful survival in sudden cardiac death. A large ongoing training program is needed to address this issue as the target population is very large and the resources often limited.

Identifying and managing those with genetic predisposition for sudden cardiac death

This approach is likely to have better yield as we are targeting a high risk population, though screening measures are likely to be costly.

Use of automated external defibrillator in important public places

Automated external defibrillators can be used with minimal training as the rhythm check is automatic and the machine gives audible prompts for the operators. But currently their use is economically feasible only in locations where large number of people are likely to assemble and use it if needed.

Implantable cardioverter defibrillators in those at high risk

Implantable defibrillators are probably the best way to prevent a sudden cardiac death. Their high cost and invasive nature limits the use to only high risk population.

Possibly the use of wearable defibrillator in those with potentially reversible risk of sudden cardiac death like in those who have recently recovered from a myocardial infarction is also another option which is worth exploring.