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(Circulation. 1997;96:2775-2777.)
© 1997 American Heart Association, Inc.

Articles

Saving Lives in the Sky

Robert A. O'Rourke, MD

From the Department of Medicine Cardiology, The University of Texas Health Science Center at San Antonio.

Correspondence to Robert A. O'Rourke, MD, Charles Conrad Brown Distinguished Professor in Cardiovascular Disease, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78284-7872.

Key Words: Editorials • fibrillation • death, sudden

	Introduction

 
Sudden cardiac death is responsible for 300 000 to 400 000 deaths yearly in the United States, depending on the definition used. When the definition is restricted to death occurring <1 hour from the onset of symptoms, patients included have a >90% incidence of an arrhythmic death.¹

Sudden cardiac death is commonly the initial manifestation of coronary heart disease. It accounts for 50% of the mortality from cardiovascular disease, which remains the main cause of death in this country.² Sudden cardiac death rates in developed countries outside the United States are similar. Approximately 75% of cardiac arrests occur at home, and about two thirds are witnessed. The chances of surviving sudden cardiac arrest are <10%, with most persons dying before reaching a hospital. Those people who do survive a cardiac arrest have a good chance of living many more years; 80% are alive at 1 year, and as many as 57% are alive at 5 years.

	Arrhythmias in Sudden Cardiac Death

 
Ventricular fibrillation is the initial recorded rhythm in 40% to 70% of patients who have cardiac arrest, depending on the patient population and the time to first recording.^{3 4} Sustained ventricular tachycardia is the first rhythm documented in fewer than 2% of sudden death victims, but it is unknown how often it precedes and precipitates ventricular fibrillation. In 157 patients who were wearing an ambulatory ECG recorder at the time of their cardiac arrest, primary ventricular fibrillation was documented in 8%, ventricular tachycardia degenerating into ventricular fibrillation in 62%, and torsades de pointes in 13% . . . [Full Text of this Article]

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