FREQUENCY OF SUDDEN CARDIAC DEATH AND PROFILES OF RISK

The epidemiology of ventricular tachycardia/fibrillation (VT/VF) and s udden cardiac death (SCD) must be explored from multiple aspects, each of which contributes insights into the problem and no one of which ex erts exclusive dominance for preventive or therapeutic strategies. The se include: (1) population dynamics, using conventional epidemiologic approaches; (2) risk as a function of time from an index event; (3) co nditioning risk factors, based on the presence of underlying disease s tates; (4) transient risk factors that are dynamic and trigger a poten tially fatal event at a specific point in time; and (5) ''response ris k,'' which refers to individual susceptibility (possibly determined ge netically) to the adverse effects of longitudinal and/or dynamic risk factors. Major inroads into profiling individual or population risk of SCD will require better understanding of each of these epidemiologic- clinical-physiologic interactions. The disciplines range from epidemio logy, through clinical medicine, to membrane channel physiology, genet ic determinants, and molecular biology. (C) 1997 by Excerpta Medica, I nc.