Sudden cardiac death is defined as an unexpected circulatory arrest usually due to a cardiac arrhythmia occurring within an hour of the onset of symptoms. It is often caused by coronary heart disease leading to cardiac arrest, most commonly ventricular fibrillation. Diagnostic tests include ECG, echocardiogram, ambulatory ECG, electrophysiology testing, MRI, and angiogram. Treatment includes drugs that block sodium channels, beta blockers, potassium channel blockers, calcium channel antagonists, drugs for cardiac remodeling, aspirin, statins, cardioverter-defibrillators, and ablation. An implantable cardioverter-defibrillator is recommended for patients with sustained ventricular tachycardia or ventricular fibrill

1. Sudden Cardiac Death
By: Dr. Ismah, Medical Department HKK
Reference: ACC/AHA/ESC 2006 guidelines for management of patients with
ventricular arrhythmias and the prevention of sudden cardiac death
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‘Death from an unexpected circulatory arrest,
usually due to a cardiac arrhythmia occurring
within an hour of the onset of symptoms’

2. • ¾ caused by CHD  cardiac arrest (commonest VF, 80%)
• Important symptoms: palpitation, pre & syncope
• Ix: ecg, echo, ambulatory ecg, intracardiac electrophysiology
testing, MRI, angiogram
• Rx: drugs (type I: fast sodium channel blockers, type II: beta
blockers, type III: repolarization potassium current blockers e.g.
amiodarone, type IV: calcium channel antagonists), drugs for
cardiac remodelling, ASA, statin, cardioverter-defibrillator, ablation
*ICD therapy should be used for treatment in patients who have
sustained VT and/or VF and who are receiving chronic optimal medical
therapy and who have reasonable expectation of survival with a good
functional status for more than 1 year
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3. Right ventricular cardiomyopathy
• Autosomal dominant, young age group
• ECG:
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4. Hypertrophic obstructive
cardiomyopathy
• Autosomal dominant
• Young, athlete
• Family history sudden death
• ECG – VT, AF, VF
• Echo – asymmetrical
septal hypertrophy
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5. Takotsuba cardiomyopathy
• Surge of stress hormone  mimic MI 
arrhythmias  cardiac death
• Ecg  mimic ant MI
• Echo: hyperkinetic/normal at basal LV while
other region of LV hypokinetic
• If survive, LV fx improves in 2 months
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6. Congenital long QT syndrome
• Commonly autosomal dominant
• Prolonged ventricle repolarization
• Elicit by stress or may occurred at rest
• Lifestyle changes, beta blocker, ICD
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7. Brugada like ECG
• Autosomal dominant
• Cardiac sodium channel gene
• >Male
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8. THANK YOU
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