Guidelines

Guideline for Ventricular Arrhythmias and Prevention of Sudden Cardiac Death (2017)

Abnormal heart rhythms, called arrhythmias, cause the heart to beat too fast, slow or unevenly. Depending on the cause, these rhythms may be harmless and may not even be noticed in patients. However, other heart rhythms are serious and increase risk for life-threatening conditions such as sudden cardiac arrest.

light bulbWhat is Sudden Cardiac Arrest?
Sudden cardiac arrest (SCA) happens when the heart suddenly stops beating. SCA is a medical emergency and can progress quickly to sudden cardiac death (SCD). If you suspect someone  is in sudden cardiac arrest, call 911 and start CPR right away.
In a guideline published by the American Heart Association, American College of Cardiology and the Heart Rhythm Society in October 2017, experts helped make clear how to reduce the risk of sudden cardiac death in patients with heart rhythm problems. Here’s what every patient should know about the recommendations.

  • This guideline applies to patients with ventricular arrhythmias, which are abnormal heart rhythms that occur in the lower chambers of the heart (ventricles). 

  • Some ventricular arrhythmias are harmless, but others are life-threatening. For example:
    • Premature ventricular complex, the least serious type,  is common and often causes no symptoms. 
    • Ventricular fibrillation, the most serious type, causes a rapid heart rhythm and is the most common cause of sudden cardiac death.

  • The recent guidelines highlight the importance of screening patients with heart rhythm problems for risk of sudden cardiac death. Some patients are at very high-risk, and it’s important they take steps to lower that risk.

  • Steps to reduce risk for sudden cardiac death can include: 
    • Keeping key risk factors for heart disease in check such as high blood pressure, high cholesterol, obesity and diabetes.
    • Taking medication.
    • Undergoing procedures. For example, an implantable cardioverter defibrillator is a device that can be placed in the chest to monitor the heart and correct dangerous rhythms. A procedure called ablation can prevent abnormal heart rhythms by destroying the heart tissue that causes them. However, treatment depends on the type of arrhythmia and each patient.

  • Shared decision making with patients and their health care professionals is important. Treatment options depend on what patients’ health goals are, what they prefer and value, as well as the best available scientific evidence.

Each year, sudden cardiac death accounts for more than 200,000 deaths in the United States. We’ve made great progress in understanding the causes of sudden cardiac death and the role of genetics in heart risk, the guideline authors say. However, more research is needed to better identify patients at high risk and to prevent this devastating condition.

Read the full text of the guidelines in the Journal of the American College of Cardiology