ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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The Prevention Of Sudden Death After Acute Myocardial Infarction: Risk Stratification
Dr. Cihangir UYANa
aKardiyoloji AD, Abant İzzet Baysal Üniversitesi İzzet Baysal Tıp Fakültesi, BOLU
Sudden cardiac death describes the unexpected natural death from a cardiac cause within a short time period, generally ≤ 1 hour from the onset of symptoms, in a person without any prior condition that would appear fatal. Such a rapid death is often attributed to a cardiac arrhythmia.
Reduced left ventricle ejection fraction remains the single most important risk factor for overall mortality and sudden cardiac death, (SCD). The prognostic value of ventricular arrhythmias in post-MI risk stratification has recently been reassessed by several studies. In the pre-thrombolytic era, non-sustained VT was a good predictor of all-cause and arrhythmic mortality post-MI. More recent studies supported the concept that SAECG is an independent predictor of arrhythmic events after MI. Autonomic markers provide information about autonomic balance. Usually, risk is increased when there are signs of reduced vagal activity to the heart. Prolongation of the QT interval is associated with increased risk for SCD post-MI. Electrophysiological testing, potentially still a useful invasive tool for early post-MI risk stratification, has progressively lost favour in the thrombolytic era. Successful reperfusion of the infarct-related artery reduces the incidence of ventricular tachyarrhythmias and SCD, possibly by increasing electrical stability at the border zone of the infarction.
Clever and balanced use of risk stratification parameters will allow appropriate therapeutic strategies to be used successfully to reduce the incidence of SCD.Keywords: Sudden cardiac death, acute myocardial infarction, risk stratificationTurkiye Klinikleri J Int Med Sci 2006, 2(42):55-61
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