Relationships Among Non-Invasive Predictors of Sudden Cardiac Death During Mental Stress and Exercise In Coronary Artery Disease Patients With Known Arrhythmic Vulnerability

摘要

Sudden cardiac death (SCD) claims 350,000 lives each year. In 80% of cases of SCD, malignant arrhythmias are the main cause. Primary prevention of SCD is often an invasive and costly procedure involving implantation of cardioverter-defibrillators (ICD). Moreover, it has been challenging to identify individuals at higher risk of SCD who may benefit from ICD prophylaxis. There is an urgent need for accurate indices to identify individuals at risk for malignant arrhythmias contributing to SCD. Several non- invasive markers have been proposed as risk stratifiers for SCD; however, none of these markers has proven to be sufficient as independent predictors of future malignant arrhythmias. It has been suggested that a complex interaction of electrical instability of the heart, compromised autonomic regulation of the heart, and damaged myocardial substrate, collectively may lead to SCD. Given that mental stress occurs frequently during daily life, there is also a need to understand how these markers interact during mental stress.