Prospective Study of Sudden Cardiac Death Among Women in the United States
ABSTRACT There are few data regarding the determinants of sudden cardiac death (SCD) in women, primarily because of their markedly lower rate of SCD compared with men. Nonetheless, existing data, although sparse, suggest possible gender differences in risk factors for SCD.
In this prospective cohort of 121 701 women aged 30 to 55 years at baseline, SCD was defined as death within 1 hour of symptom onset. From 1976 to 1998, 244 SCDs were identified. Although the risk of SCD increased markedly with age, the percentage of cardiac deaths that were sudden decreased. Most (69%) women who suffered a SCD had no history of cardiac disease before their death. However, almost all of the women who died suddenly (94%) had reported at least 1 coronary heart disease risk factor. Smoking, hypertension, and diabetes conferred markedly elevated (2.5- to 4.0-fold) risk of SCD, similar to that conferred by a history of nonfatal myocardial infarction (relative risk, 4.1; 95% confidence interval, 2.9 to 6.7). Family history of myocardial infarction before age 60 years and obesity were associated with moderate (1.6-fold) elevations in risk. With regard to mechanism, 88% of SCDs were classified as arrhythmic. In 76% of these, the first rhythm documented was ventricular tachycardia or ventricular fibrillation.
These prospective data suggest that, as in men, coronary heart disease risk factors predict risk of SCD in women and that SCD is usually an arrhythmic death. Therefore, prevention of atherosclerosis or ventricular arrhythmias may reduce the incidence of SCD in women.
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ABSTRACT: Life-threatening ventricular arrhythmias remain the main cause of death among patients with cardiovascular diseases. Efforts have been spent on early detection of such fatal cardiac signs. We have previously reported a novel chaotic phase space differential (CPSD) algorithm in discriminating VPC, VT, and VF from normal sinus rhythm with both good sensitivity and specificity. In this article, we apply this algorithm on the rat model of calcium induced ventricular tachycardia. Peaked CPSD values can be observed along with the occurrence of ventricular tachycardia. In addition, minor ECG changes such as new onset S wave or sinus arrhythmia can also be noted on CPSD tracing. We believe that the CPSD algorithm not only is capable of detecting lethal ventricular arrhythmias, but also is potentially a good tool for long-term monitoring the change of ECG signals.Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 07/2013; 2013:2152-2155. DOI:10.1109/EMBC.2013.6609960
Article: This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Neurologic Prognosis after Cardiac Arrest