Therapeutic developments in sudden cardiac death

Sudden cardiac death is characterised by the unexpected death of a patient who has been clinically stable. It is frequently due to the development of ventricular tachyarrhythmias. With appropriate treatment, patients can be a ppropriately resuscitated. Clinically, it is essential to develop treatment strategies to prevent such an episode, as most patients do not survive our -of-hospital cardiac arrest. beta -Blockers are an effective pharmacologica l therapy in patients following myocardial infarction and in those with con gestive heart failure. They may also be effective in other types of heart d isease. Anti-arrhythmic agents are not useful as prophylactic drug therapy for reducing mortality in patients at risk for sudden cardiac death. Amioda rone is a notable exception, which may have some benefit, particularly in s ome subgroups. The implantable cardioverter-defibrillator has emerged as th e most effective therapy for preventing sudden cardiac death in high-risk p atients. Further work is required to enhance the characterisation of high-r isk patients. Genetic analyses in patients with cardiovascular disorders ma y also identify new approaches to the prevention of sudden cardiac death.