1. PREDICT AND PREVENT SUDDEN CARDIAC DEATH

2. Sudden Cardiac Death Prediction and Prevention: Report From a National Heart, Lung, and Blood Institute and Heart Rhythm Society Workshop By Glenn I. Fishman, Sumeet S. Chugh, John P. DiMarco, Christine M. Albert, Mark E. Anderson, Robert O. Bonow, Alfred E. Buxton, Peng-Sheng Chen, Mark Estes, Xavier Jouven, Raymond Kwong, David A. Lathrop, Alice M. Mascette, Jeanne M. Nerbonne, Brian O'Rourke, Richard L. Page, Dan M. Roden, David S. Rosenbaum, Nona Sotoodehnia, Natalia A. Trayanova and Zhi-Jie Zheng http://circ.ahajournals.org/content/122/22/2335 3. Predicting and Preventing Sudden Cardiac Death By N.A. Mark Estes III http://circ.ahajournals.org/content/124 /5/651 4. Prediction of Sudden Cardiac Death by Fractal Analysis of Heart Rate Variability in Elderly Subjects By Timo H. Makikallio, MD,* Heikki V. Huikuri, MD, FACC, Anne Makikallio, MD, Leif B. Sourander, MD, Raul D. Mitrani, MD, FACC,* Agustin Castellanos, MD, FACC,* Robert J. Myerburg, MD, FACC* http://content.onlinejacc.org 5. with the title Predicting and Preventing Sudden Cardiac Death By N.A. Mark Estes III 6. 1. Structure The journals structure is really systematic. The author divide it into several part and explain it based on his research implicitly and clearly. Start from the case review, overview, pathophysiology, prevention until the conclusion of the research. Beside that, the author put the table, picture and graphic as the supporting fact. 7. Overview Sudden cardiac death (SCD) from cardiac arrest is the most common cause of death worldwide, accounting for 50% of all deaths from cardiovascular disease. Prevention of Sudden Cardiac Death Multiple strategies have evolved to predict and prevent SCD. One strategy receiving recent emphasis is primordial prevention of coronary artery disease. Prevention of Sudden Cardiac Death After Myocardial Infarction Current clinical guidelines restrict ICD implants to patients at least 40 days after MI with continued impairment of left ventricular function while on optimal medical therapy. 8. 2. Content In the journal, the author always put the fact based on other valid research before. It make sure that the authors journal is valid. The language that used by the author is easy enough to understand, it can be read by usual people. The author divide the prevention into several part too, based on the case or patient condition. 9. On average, only 8% of those receiving community- based resuscitation are discharged from the hospital alive. In 50% of cases, SCD is the first manifestation of the coronary disease. A recent retrospective observational study suggests that targeted deployment in locations with a high incidence of cardiac arrest could improve outcomes in a more cost-effective manner. 10. There are many opportunities for clinicians to improve outcomes of cardiac arrest through preventive measures in their practice, resuscitation programs in their community, and postresuscitation care protocols in their hospital. There has been a notable decrease in the incidence of cardiac arrest from ventricular fibrillation recently. Multiple factors are likely to contribute to this decline. 11. Primary prevention of SCD with risk stratification and intervention in those individuals with established cardiovascular disease placing them at high risk is another strategy to improve outcomes. The most common underlying cardiovascular condition predisposing to SCD is coronary artery disease. Multiple clinical trials randomizing several thousand patients have demonstrated that the ICD prevents sudden death and significantly reduces overall mortality among patients with left ventricular dysfunction. 12. Secondary prevention refers to clinical intervention in patients who have survived a prior cardiac arrest or sustained ventricular tachycardia. In these patients, the ICD has proven superior to antiarrhythmic drug therapy for prolonging survival. Two recent trials showed no improvement in mortality with early placement of an ICD in patients at high risk of SCD after MI. Recent autopsy evaluation of patients experiencing sudden cardiac arrest in the immediate post-MI period indicates that there is a high frequency of cardiac rupture or recurrent MI in the first month after the index MI. 13. The concept of the chain of survival was developed to underscore the critical importance of the time-sensitive steps that each independently improve the outcome of cardiac arrest. The chain of survival includes a strategy of training and equipping members of the lay population to perform cardiopulmonary resuscitation and defibrillation with an automated external defibrillator when a cardiac arrest occurs through local public access to defibrillation programs. 14. Sudden Cardiac Death (SCD) is one thing that we must know and clinicians have responsible to give knowledge to the citizen about it. About the fact, the risk and especially how to predict and to prevent it. From the journal we know that prediction of SCD linked with coronary heart disease risk factors, include advanced age, male sex, cigarette smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity, and a family history. So, we have to prevent effectively that factors. The chain survival is important too. This early emergency medical service really help patient. At least, we must have knowledge about resuscitation.