Heart Disease and Sudden Cardiac Death
Can Sudden Cardiac Death Be Prevented? continued...
If you have questions or are unsure how make these changes, talk to your doctor. Patients and families should know the signs and symptoms of coronary artery disease and the steps to take if symptoms occur.
Medications: To help reduce the risk of sudden cardiac arrest, doctors may prescribe medications to people who have had heart attacks or who have heart failure or arrhythmias such as irregular heart rhythms. These drugs may include ACE inhibitors, beta-blockers, calcium-channel blockers, and other antiarrhythmics. For patients with high cholesterol and coronary artery disease, statin drugs may be prescribed.
If medication is prescribed, your doctor will give you more specific instructions. It is important that you know the names of your medications and any directions that you need to follow when taking them. If you have any questions, be sure to ask your doctor or pharmacist.
Implantable cardioverter-defibrillator (ICD): For people whose risk factors put them at great risk for sudden cardiac death, an ICD may be inserted as a preventive treatment. An ICD is a small machine similar to a pacemaker that is designed to correct arrhythmias. It detects and then corrects a fast heart rate. The ICD constantly monitors the heart rhythm. When it detects a very fast or slow heart rhythm, it delivers energy (a small, but powerful shock) to the heart muscle to cause the heart to beat in a normal rhythm again. The ICD also records the data of each abnormal heartbeat, which can be viewed by the doctor using a special machine kept at the hospital.
The ICD may be used in patients who have survived sudden cardiac arrest and need their heart rhythms constantly monitored. It may also be combined with a pacemaker to treat other underlying irregular heart rhythms.
Interventional Procedures or Surgery: For patients with coronary artery disease, an interventional procedure such as angioplasty (blood vessel repair) or bypass surgery may be needed to improve blood flow to the heart muscle and reduce the risk of SCD. For patients with other conditions, such as hypertrophic cardiomyopathy or congenital heart defects, an interventional procedure or surgery may be needed to correct the problem. Other procedures may be used to treat abnormal heart rhythms, including electrical cardioversion and catheter ablation.
When a heart attack occurs in the left ventricle (left lower pumping chamber of the heart), a scar forms. The scarred tissue may increase the risk of ventricular tachycardia. The electrophysiologist (doctor specializing in electrical disorders of the heart) can determine the exact area causing the arrhythmia. The electrophysiologist, working with your surgeon, may combine ablation (the use of high-energy electrical energy to "disconnect" abnormal electrical pathways within the heart) with left ventricular reconstruction surgery (surgical removal of the infarcted or dead area of heart tissue).
Educate Your Family Members: If you are at risk for SCD, talk to your family members so they understand your condition and the importance of seeking immediate care in the event of an emergency. Family members and friends of those at risk for SCD should know how to perform CPR. Classes to teach this are available in most communities.