Sudden cardiac death occurs quickly and usually completely unexpectedly. Approximately 65,000 people in Germany die from it every year. This corresponds to 20 percent of all deaths caused by cardiovascular diseases. First, severe cardiac arrhythmia occurs, followed by cardiac arrest within a few minutes. The people affected lose consciousness and their normal breathing stops.
There is only a chance of survival if countermeasures are started immediately. Because with every minute that the heart stops, the chance of survival of the person affected decreases by ten percent. Ideally, an emergency call is first made and then a cardiac massage and possibly mouth-to-mouth resuscitation is started. If available, a defibrillator should also be used. These devices emit electrical impulses that can bring the heart back to its normal rhythm. The rescue service cares for the patient on site and transfers him/her to a clinic where the treatment is continued.
If the patient survives the sudden cardiac arrest, the further course of treatment depends decisively on how quickly appropriate countermeasures are taken. For example, severe brain damage can occur if too much time passes until successful resuscitation. To prevent a renewed cardiac arrest, patients are implanted with a defibrillator. When cardiac arrhythmias occur, these small devices send out electrical signals to stop them.
In principle, sudden cardiac death can be caused by any disease that triggers cardiac arrhythmia – for example, diseases of the coronary vessels, which usually affect middle-aged people. In 80 percent of cases, cardiac arrhythmia is triggered by an unforeseeable heart attack. Other causes include cardiac arrhythmias caused by heart muscle diseases and congenital heart defects. In only about 13 percent, real risk patients are affected. These include people who have had a heart attack that has led to significant heart failure. They also include people with other known heart diseases who should be fitted with an implantable defibrillator as a precautionary measure according to current guidelines.
It is predominantly older people who are affected by sudden cardiac death. But young people can also be affected. Often, this is due to an unknown congenital heart disease that leads to sudden cardiac death under heavy physical stress, such as competitive sports.
The best prevention of sudden cardiac death is regular examinations of the heart to detect and treat possible diseases at an early stage.
DZHK studies on sudden cardiac death
TOMAHAWK-DZHK4 – Immediate unselected coronary angiography versus delayed triage in survivors of out-of-hospital cardiac arrest without ST-segment elevation
SMART-MI-DZHK9 – Implantable cardiac monitors in high-risk post-infarction patients with cardiac autonomic dysfunction