Circulation, Vol 90, 2534-2539, Copyright © 1994 by American Heart Association
GF Tomaselli, DJ Beuckelmann, HG Calkins, RD Berger, PD Kessler, JH Lawrence, D Kass, AM Feldman and E Marban
Congestive heart failure is a common, highly lethal cardiovascular disorder
claiming over 200,000 lives a year in the United States alone. Some 50% of
the deaths in heart failure patients are sudden, and most of these are
probably the result of ventricular tachyarrhythmias. Methods designed to
identify patients at risk have been remarkably unrewarding, as have
attempts to intervene and prevent sudden death in these patients. The
failure to impact favorably on the incidence of sudden death in heart
failure patients stems largely from a lack of understanding of the
underlying mechanisms of arrhythmogenesis. This article explores the role
of abnormalities of ventricular repolarization in heart failure patients.
We will examine evidence for the hypothesis that alteration of repolarizing
K+ channel expression in failing myocardium predisposes to abnormalities in
repolarization that are arrhythmogenic. The possible utility of novel
electrophysiological and ECG measures of altered ventricular repolarization
will be explored. Understanding the mechanism of sudden death in heart
failure may lead to effective therapy and more accurate identification of
patients at greatest risk.
ARTICLES
Sudden cardiac death in heart failure. The role of abnormal repolarization
Johns Hopkins School of Medicine, Baltimore, MD 21205.
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