Vol 5, No 4 (2014)

The prevalence of sudden cardiac death in the United States and European countries is very high, reaching 1‰ in population. Its share in the total mortality rate is around 13%, in the structure of cardiovascular mortality - about 40%. The lack of official statistics and large multicenter studies in our country do not allow us to estimate the true extent of the problem, but based on the calculated data, we can suppose that annually 200-250 thousand people died suddenly in Russian Federation. This question becomes especially important in working age population - the most significant economic and social part of society. In this population the proportion of sudden cardiac mortality can exceed 50%, and the features of nosological structure require different approaches for prevention, both at individual and population level.

Sudden cardiac death - a non-violent death, which developed instantly or within one hour from the time of acute changes in the clinical status of patient, which is based on cardiac causes. The main cause of SCD is coronary heart disease, which accounts for 80% of all cases. More than half of that cases are associated with acute disorders of the coronary circulation. Sudden cardiac death is a leading cause of mortality in patients with coronary artery disease. All activities that improve the prognosis in patients with coronary artery disease, reduce the risk of sudden cardiac death. Methods of direct myocardial revascularization allowed to improve radically the quality of life and prognosis in patients with coronary artery disease. Interventional treatment is highly effective and widely used method of direct myocardial revascularization, plays a crucial role in improving life expectancy of patients with ischemic heart disease, including through the prevention of sudden cardiac death.

The review discusses accumulated to date scientific data on dilated cardiomyopathy: causative factors, clinical manifestations, sudden cardiac death in patients with the disease and its risk-stratification in the light of National guidelines on the definition of risk and prevention of sudden cardiac death (2012). A case of a patient with dilated cardiomyopathy and high-risk of sudden cardiac death is presented.

In the review epidemiologic data regarding sudden cardiac death in patients with metabolic syndrome are presented. Suspected pathophysiologic mechanisms and approaches to primary prevention of this event are considered.

Risk stratification of ventricular tachyarrhythmia in patients without structural heart disease is still one of the most important question that requires the answer. We now demonstrate our attempt of risk stratification for this group of patients, taking into account their anamnestic and history data and instrumental research results.