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Incidence of and risk stratification for sudden cardiac death after acute myocardial infarction

Authors
Philip J Podrid, MD, FACC
Leonard I Ganz, MD, FHRS, FACC
Section Editors
Peter J Zimetbaum, MD
Bernard J Gersh, MB, ChB, DPhil, FRCP, MACC
Deputy Editor
Brian C Downey, MD, FACC

INTRODUCTION

The process of risk stratification in a patient who has had an acute myocardial infarction (MI) has two components:

Early in-hospital identification of patients at increased risk for recurrent ischemic events

Identification of patients at increased risk for arrhythmic or nonarrhythmic death

Patients who have had an acute MI are at increased risk for sudden cardiac death (SCD), most often due to a ventricular tachyarrhythmia. However, not all post-MI patients have the same risk of SCD. Thus, the therapeutic approach to the prevention of SCD depends upon the identification of those patients who are most likely to have a ventricular tachyarrhythmia and the effectiveness of the available preventive measures [1,2].

The incidence of SCD after acute MI and identification of patients at increased risk for SCD will be reviewed here. Issues related to the primary prevention of arrhythmic death, to the treatment of patients who have already experienced a serious sustained ventricular arrhythmia (secondary prevention), and to risk stratification for recurrent ischemic events after ST elevation and non-ST elevation infarctions are discussed separately. (See "Clinical features and treatment of ventricular arrhythmias during acute myocardial infarction" and "Sustained monomorphic ventricular tachycardia in patients with a prior myocardial infarction: Treatment and prognosis" and "Risk stratification after acute ST-elevation myocardial infarction" and "Risk stratification after non-ST elevation acute coronary syndrome" and "Primary prevention of sudden cardiac death in heart failure and cardiomyopathy".)

                          

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Literature review current through: Nov 2016. | This topic last updated: Fri Oct 31 00:00:00 GMT+00:00 2014.
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