The Agency for Healthcare Research ...

The Agency for Healthcare Research and Quality has released a recently made known report on sudden cardiac death. "Treatment to obstruct Sudden Cardiac Death" is available online at http://www.ahrq. gov/clinic/suddcard.htm.

single in kind fourth of all deaths in the United States are attributed to rapid cardiac death, which is unexpect and take places within an hour of symptom attack Sudden cardiac death often is linked to ventricular arrhythmia.

Patients at risk for quickly prepared cardiac death should be identified and considered for interventions to change into their risk of sudden death or improve their quality of life. Treatments include put drugs into therapy and implantable cardiac defibrillators (ICDs).

Considerable variation exists in the use of ICDs, suggesting that physicians are uncertain as to when they should be used, or that like decisions are being driven by way of nonclinical factors. The challenge of identifying those patients best suited for ICD implantation remains. The following are guide findings included in the report:

* The impressed sign I antiarrhythmic drugs (sodium channel blockers) are no longer considered helpful and have been associated with an increase in mortality rates among the public at risk for sudden cardiac death. one type III antiarrhythmic drugs (potassium channel blockers) including amiodarone and sotalol, are effective.

* Surgically implanting an ICD to monitor and correct the heart rate can furnish additional help. When ICDs are combined with other therapy, as it was as amiodarone, the ICDs can cut short mortality by about 25 percent ICDs appear to be principally effective for patients who had an episode of sustained ventricular tachycardia or ventricular fibrillation. Evidence is not as mighty for patients who had an earlier myocardial infarction and have a grave ejection fraction.

* ICD use increased more than tenfold According to Medicare data, mortality rates have fallen from 6 to 19 percent for the first 30 days after device implantation and from 193 to 114 percent for the year following implantation between 1987 and 1995 It could not be determined whether these better issues were the result of improved effectiveness of the device or improved patient selection.

* ICDs and antiarrhythmic medications to impede sudden cardiac death are effective in reducing deaths, unless their impact on quality of life is les clear. In patients with of recent origin cases of life-threatening ventricular arrhythmias, quality of life was shown to decrease at first if it be not that gradually improve with time. The overall improvements in quality of life were greater for patients with ICDs than for patients treated sole with amiodarone. These findings, which contrast with previous research, may muse advances in ICD technology and differences in consideration populations.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group