Sudden Cardiac Death (SCD) - Surgery, AICD, Catheter Ablation

Dateline: 11/29/98

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

Stage 3 - Therapy by surgery, implantable devices or catheter ablation

Surgery is offered only for those patients who have suitable anatomy and physiology. Post-operative testing for the arrhythmia is mandatory, and if operation is successful, it cannot be induced post-operatively.

Automatic Implantable Cardioverter / Defibrillator (AICD) devices are used in those who are not surgical candidates but still at high risk of recurrent episodes of cardiac arrest. These devices are implanted by an operation, and automatically defibrillate the heart in the event of a life threatening arrhythmia, thus aborting a cardiac arrest scenario. Drugs might be needed in addition to reduce the frequency of defibrillations in individual patients.

Catheter ablation is rarely useful in ventricular arrhythmias, and often is used as an adjunct to surgery or implantable devices.

Is Sudden Cardiac Death a risk to Public Safety ?

Can SCD harm the general public ? What if the driver of a car heading towards me has a SCD attack ?

Despite concerns, large studies have revealed very few instances where a SCD episode has directly harmed bystanders. However, survivors of SCD should be prohibited from occupations like driving a school bus, piloting aircraft and driving a truck or other heavy vehicle. With regard to automobile drivers having SCD attacks, most of the data show that cardiac arrest at the wheel usually involves enough of a prodrome stage to allow the driver to get to the roadside before losing consciousness !

Also, any intervention to minimize the risk from SCD designed for the general population would be applied to the 999 out of 1000 who will not have an SCD event (the incidence of SCD is 1 to 2 per 1000 population). Cost and risk-to-benefit uncertainties limit the nature of such broad based interventions.

The End - it's but a beginning

Griffith Joyner, who won gold medals in the 100- and 200-meter dash and the 400-meter relay at the Seoul Olympic Games, exuded an appearance of good health, as have other major athletes who have died young. They have died of Sudden Cardiac Death syndrome. Hopefully the knowledge you have gained from this series of articles will help save a life some day. I dedicate this chapter on SCD to the memory of one of my favorite athletes - FLORENCE GRIFFITH JOYNER.

Florence said: "We're trying to get Americans up, fit and moving, try to learn how to live a healthy lifestyle. Get kids to put down the video games, get up, moving." And she preached to them, "You never fail until you stop trying." Her heart may have failed. But she didn't. Florence Griffith Joyner was an inspiration. May her soul rest in peace.

Recommended Reading :

Sudden Cardiac Death : Strategies for the 90s
Richard M. Luceri(Editor) / Published 1992
Buy it from Amazon.com. Visit the Heart Bookstore for more titles on SCD.

To learn more about Sudden Cardiac Death syndrome, read the other articles in this series.