Guide Ventricular Fibrillation and Sudden Coronary Death (Developments in Cardiovascular Medicine)

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Download "Reflections - Summer " The Author. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study.

Cardiac arrest, Sudden Cardiac Death, Sudden Cardiac Arrest, Sudden Death

Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Mortality trends in patients diagnosed with first atrial fibrillation: a year community-based study. J Am Coll Cardiol. Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation.

Eur Heart J. Prognostic significance of atrial fibrillation in advanced heart failure: a study of patients. Atrial fibrillation during acute myocardial infarction: association with all-cause mortality and sudden death after 7-years of follow-up. Int J Clin Pract. Independent risk factors for atrial fibrillation in a population-based cohort: the Framingham Heart Study. Long- and short-term risk of sudden coronary death. Coronary atherosclerosis as a cause of unexpected and unexplained death: an autopsy study from Incidence of and risk factors for atrial fibrillation in older adults.

ARIC Investigators. Am J Epidemiol. The Cardiovascular Health Study: design and rationale. Ann Epidemiol. Am Heart J. J Clin Epidemiol. Electrocardiographic and clinical predictors separating atherosclerotic sudden cardiac death from incident coronary heart disease. Long-term prognosis associated with J-point elevation in a large middle-aged biracial cohort: the ARIC study. The effects of cycle length on cardiac refractory periods in man.

Facilitation of ventricular tachycardia induction with abrupt changes in ventricular cycle length. Am J Cardiol. Enhancement of myocardial vulnerability by atrial fibrillation. Am J Ther. Association between atrial fibrillation and appropriate implantable cardioverter defibrillator therapy: results from a prospective study. J Cardiovasc Electrophysiol. Nat Genet. Save Preferences. Privacy Policy Terms of Use. This Issue.

Views 6, Citations View Metrics. Original Investigation. Lin Y. Yee, MS ; Susan R. Invited Commentary. Study populations. ARIC Study. Cardiovascular Health Study. Ascertainment of af. Outcomes ascertainment. Statistical analysis.

Sudden Death and Defibrillation (Paul Schurmann, MD)

Af, scd, and nscd. Back to top Article Information. Conflict of Interest Disclosures: None reported. Sign in to access your subscriptions Sign in to your personal account. The echocardiogram subgroup analysis confirmed that many of the risk factors identified in the original analysis remained independent predictors of SCD risk after including LVEF. Prior MI and physical inactivity likely cosegregate with LV function, as the inclusion of LVEF in the subgroup analysis precluded their addition to the model.

Finally, although LVEF measures were not standardized in a core imaging laboratory, their assessment via chart review mimics echocardiographic-based methods of risk stratification in clinical practice. Furthermore, echocardiograms were not obtained at the outset of the study unlike other predictors of SCD in our study; however, the application of a LVEF measure from earlier time points also represents clinical practice.

Several limitations of our study should be considered. First, the limited number of SCD events may have resulted in a relatively small number of potential risk factors. Also, we did not validate our prediction model in other cohorts. Future studies will require collaborations across multiple cohorts to refine further SCD risk discrimination and to provide a means for both replication and cross-validation.

Most women in this analysis were white; therefore, further assessment is required in postmenopausal women of other ethnicities. Left ventricular ejection fraction, a powerful predictor of risk for SCD, was not measured in all the participants of this study. Although we included a separate subgroup analysis, our findings may be limited given the lower number of SCD events. Finally, the variables identified in our analysis also appeared to be associated with non-SCD. This current limitation in risk prediction will require future studies to identify unique predictors of SCD. A simple risk stratification based on the number of risk factors predicted a fold gradient in the incidence of SCD.

Future projects should focus on combining studies to allow more robust estimates for established risk factors and to identify additional markers that augment the predictive ability of an SCD risk model. Deo uphs. Published Online: July 25, Acquisition of data : Hulley. Drafting of the manuscript : Deo and Vittinghoff. Critical revision of the manuscript for important intellectual content : Deo, Lin, Tseng, Hulley, and Shlipak. Statistical analysis : Vittinghoff and Lin. Administrative, technical, and material support : Deo, Tseng, Hulley, and Shlipak.

Study supervision : Shlipak. All Rights Reserved. View Large Download. Table 1. Baseline Characteristics Across Categories of Death.


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  4. Table 2. Table 3. Net Reclassification Improvement a. Prospective study of sudden cardiac death among women in the United States. Sudden coronary death in women. Am Heart J. J Am Coll Cardiol. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. Gender differences in ventricular arrhythmia recurrence in patients with coronary artery disease and implantable cardioverter-defibrillators.

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    Sudden Cardiac Death | Circulation

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    A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. Control Clin Trials. Cardiovascular disease outcomes during 6.

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    Stat Med. Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond. Sudden death due to cardiac arrhythmias. Limitations of ejection fraction for prediction of sudden death risk in patients with coronary artery disease: lessons from the MUSTT study.