Sudden Cardiac Death (SCD) - Advanced Cardiac Support

Dateline: 11/15/98

Have you read my previous article on SCD syndrome - Sudden Cardiac Death - Management ?

Advanced Life Support (ALS) and Definitive Resuscitation

The targets in ALS are

• to optimize respiration
• return cardiac rhythm to an effective pattern
• maintain and support the restored circulation

These can be done by

1. passing a breathing tube into the airways
2. restoring heart rhythm by defibrillation or pacing
3. inserting an intravenous line by which medications can be administered

Post cardiac arrest care and long term management

On the basis of extensive studies, algorithms have been developed to optimize the treatment of these survivors of SCD/Cardiac arrest. The aim of all these interventions is to prevent the SCD episode happening again. The three stage approach is detailed here:

• Establish the cause of SCD / Cardiac arrest
• Advanced electrophysiological evaluation
• Therapy by surgery, implantable devices or catheter ablation

Stage 1 - Establishing a cause for SCD

If the SCD event was triggered by a new heart attack, the management protocol is the same as for any patient who has had a heart attack.

If the event was due to arrhythmia-provoking factors, conventional protocols for treatment of arrhythmia disorders is followed.

If the SCD / Cardiac arrest is due to long standing lowering of heart blood supply due to coronary artery disease (ischemic heart disease) or due to other non-ischemic diseases, further advanced electrophysiological evaluation is warranted.

Recommended Reading :

Sudden Death : Cardiac and Other Causes
Donald B., M.D. Hackel, Keith A., M.D., Ph.D. Reimer / Hardcover /Published 1993
Buy it from Amazon.com. Visit the Heart Bookstore for more titles on SCD.

To learn more about Sudden Cardiac Death syndrome, read the next article in this series.