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Reviews in Cardiovascular Medicine Mar 2021Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in... (Review)
Review
Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and the role of new technologies in the field. Further, we delineate the current epidemiologic trends and pathogenesis. In particular, we describe the advancement in molecular autopsy and genetic testing, the role of target temperature management, extracorporeal membrane oxygenation (ECMO), cardiopulmonary resuscitation (CPR), and transvenous and subcutaneous implantable cardioverter devices (ICDs).
Topics: Death, Sudden, Cardiac; Defibrillators, Implantable; Humans
PubMed: 33792256
DOI: 10.31083/j.rcm.2021.01.207 -
The Lancet. Neurology Sep 2016Sudden unexpected death in epilepsy (SUDEP) can affect individuals of any age, but is most common in younger adults (aged 20-45 years). Generalised tonic-clonic seizures... (Review)
Review
Sudden unexpected death in epilepsy (SUDEP) can affect individuals of any age, but is most common in younger adults (aged 20-45 years). Generalised tonic-clonic seizures are the greatest risk factor for SUDEP; most often, SUDEP occurs after this type of seizure in bed during sleep hours and the person is found in a prone position. SUDEP excludes other forms of seizure-related sudden death that might be mechanistically related (eg, death after single febrile, unprovoked seizures, or status epilepticus). Typically, postictal apnoea and bradycardia progress to asystole and death. A crucial element of SUDEP is brainstem dysfunction, for which postictal generalised EEG suppression might be a biomarker. Dysfunction in serotonin and adenosine signalling systems, as well as genetic disorders affecting cardiac conduction and neuronal excitability, might also contribute. Because generalised tonic-clonic seizures precede most cases of SUDEP, patients must be better educated about prevention. The value of nocturnal monitoring to detect seizures and postictal stimulation is unproven but warrants further study.
Topics: Death, Sudden; Epilepsy; Humans
PubMed: 27571159
DOI: 10.1016/S1474-4422(16)30158-2 -
Revista Espanola de Cardiologia... Nov 2012Sudden death is probably the greatest challenge in modern cardiology. After reviewing its history, we describe the epidemiology of sudden death and its associated... (Review)
Review
Sudden death is probably the greatest challenge in modern cardiology. After reviewing its history, we describe the epidemiology of sudden death and its associated diseases. We highlight its physiopathologic aspects, including the factors that act on vulnerable myocardium triggering the final arrhythmia, mainly ventricular fibrillation and, to a lesser extent, bradycardia and sudden death. We emphasize the relevance of acute ischemia, ventricular dysfunction and genetic factors, not only in genetic heart disease, but also as triggers of sudden death in acute and chronic ischemic heart disease. Finally, we describe the best way to identify candidates at risk, discuss how to prevent sudden death, and outline the best approach to managing a patient resuscitated from cardiac arrest. Full English text available from:www.revespcardiol.org.
Topics: Age Factors; Arrhythmias, Cardiac; Cardiopulmonary Resuscitation; Death, Sudden; Humans; Risk Assessment
PubMed: 22959179
DOI: 10.1016/j.recesp.2012.03.032 -
Current Opinion in Pediatrics Aug 2021Despite many years of study, sudden unexplained death remains a tenuous diagnosis of exclusion. Here, we discuss the current science behind the uncertainties of sudden... (Review)
Review
PURPOSE OF REVIEW
Despite many years of study, sudden unexplained death remains a tenuous diagnosis of exclusion. Here, we discuss the current science behind the uncertainties of sudden death, as well as the questions that still remain.
RECENT FINDINGS
Failure in any part of the complex interplay between peripheral sensors and central cardiorespiratory regulation can result in sudden death. Diagnostic testing with electrocardiograms, electroencephalogram, sleep studies, or even genetic studies have increased our ability to identify patients at the highest risk.
SUMMARY
Advances in the understanding of sudden unexplained death in children may show common pathways leading to sudden death from multiple different diseases. Although rare, the devastating implication prioritizes the importance in educating patients about how to live with the risk of sudden death.
Topics: Child; Death, Sudden; Electrocardiography; Humans; Infant
PubMed: 34226427
DOI: 10.1097/MOP.0000000000001032 -
Acta Neurologica Scandinavica Dec 2022Sudden unexpected death in epilepsy (SUDEP) is the major cause of premature death in epilepsy patients, particularly those with refractory epilepsy. Sudden unexpected... (Review)
Review
Sudden unexpected death in epilepsy (SUDEP) is the major cause of premature death in epilepsy patients, particularly those with refractory epilepsy. Sudden unexpected death in epilepsy is thought to be related to peri-ictal cardiac dysfunction, respiratory depression, and autonomic dysfunction, albeit the exact etiology is unknown. Sudden unexpected death in epilepsy prevention remains a huge challenge. The sole presence and frequency of generalized tonic-clonic seizures (GTCS) are the most important risk factors for SUDEP, and nocturnal monitoring may lower the risk with the use of remote listening devices. In addition, studies in animal models of SUDEP have discovered that multiple neurotransmitters, including serotonin (5-HT) and adenosine, may be involved in the pathophysiological mechanisms of SUDEP and that these neurotransmitters could be the targets of future pharmacological intervention for SUDEP. The latest research findings on the epidemiology, clinical risk factors, and probable causes of SUDEP are presented in this review.
Topics: Animals; Humans; Sudden Unexpected Death in Epilepsy; Death, Sudden; Epilepsy; Seizures; Risk Factors; Serotonin
PubMed: 36358030
DOI: 10.1111/ane.13715 -
Ugeskrift For Laeger Jun 2022Sudden and unexpected death is defined as sudden death without any obvious cause and where the person was seen in habitual conditions within the last 24 hours before... (Review)
Review
Sudden and unexpected death is defined as sudden death without any obvious cause and where the person was seen in habitual conditions within the last 24 hours before death. Persons with epilepsy have a 34-fold increased risk of dying suddenly and unexpectedly compared with the background population. In persons with epilepsy these deaths are referred to as sudden unexpected death in epilepsy (SUDEP). This review finds that the risk is highest in younger adults, and SUDEP is the second leading cause of death in persons with epilepsy aged 1-49 years. Good seizure control is important in the prevention of SUDEP.
Topics: Adult; Death, Sudden; Epilepsy; Humans; Referral and Consultation; Sudden Unexpected Death in Epilepsy
PubMed: 35786225
DOI: No ID Found -
JACC. Clinical Electrophysiology Aug 2023
Topics: Humans; Schizophrenia; Death, Sudden, Cardiac; Heart Arrest
PubMed: 37115116
DOI: 10.1016/j.jacep.2023.02.011 -
Neurologic Clinics Nov 2022Persons with epilepsy (PWE) have an up to 34-fold increased risk of dying suddenly and unexpectedly compared with the general population. Despite being potentially... (Review)
Review
Persons with epilepsy (PWE) have an up to 34-fold increased risk of dying suddenly and unexpectedly compared with the general population. Despite being potentially preventable by optimal care, sudden unexpected death in epilepsy (SUDEP) is one of the most frequent causes of death in PWE, especially in children and younger adults. The incidence of SUDEP in the general epilepsy population is rather consistent at 1.2 to 1.3 per 1000 person-year across series. Several risk factors for SUDEP have been identified, but with focal-to-bilateral or generalized tonic-clonic seizures and sleeping alone as the most significant. Thereby, optimal care and nocturnal surveillance might decrease the risk of SUDEP. Finally, PWE wants information about SUDEP, and providing this information might increase adherence to the treatment and thereby good seizure control. This narrative review provides an update on SUDEP.
Topics: Adult; Child; Humans; Sudden Unexpected Death in Epilepsy; Death, Sudden; Epilepsy; Seizures; Risk Factors
PubMed: 36270688
DOI: 10.1016/j.ncl.2022.06.001 -
Developmental Medicine and Child... Sep 2023Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality in children and adults living with epilepsy. The incidence of SUDEP is... (Review)
Review
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality in children and adults living with epilepsy. The incidence of SUDEP is comparable in both children and adults; it is approximately 1.2 per 1000 person years. The pathophysiology of SUDEP is not well understood but may involve mechanisms such as cerebral shutdown, autonomic dysfunction, altered brainstem function, and cardiorespiratory demise. Risk factors for SUDEP include the presence of generalized tonic-clonic seizures, nocturnal seizures, possible genetic predisposition, and non-adherence to antiseizure medications. Pediatric-specific risk factors are not fully elucidated. Despite recommendations from consensus guidelines, many clinicians still do not follow the practice of counseling their patients about SUDEP. SUDEP prevention has been an area of important research focus and includes several strategies, such as obtaining seizure control, optimizing treatment regimens, nocturnal supervision, and seizure detection devices. This review discusses what is currently known about SUDEP risk factors and reviews current and future preventive strategies for SUDEP.
Topics: Adult; Humans; Child; Sudden Unexpected Death in Epilepsy; Death, Sudden; Seizures; Risk Factors; Epilepsy, Reflex
PubMed: 36802063
DOI: 10.1111/dmcn.15553 -
Epilepsy & Behavior : E&B Jul 2022People with epilepsy (PWE) may die suddenly and unexpectedly and without a clear under-lying pathological etiology; this is called SUDEP (sudden unexpected death in... (Review)
Review
People with epilepsy (PWE) may die suddenly and unexpectedly and without a clear under-lying pathological etiology; this is called SUDEP (sudden unexpected death in epilepsy). The pooled estimated incidence rate for SUDEP is 23 times the incidence rate of sudden death in the general population with the same age. Empowering healthcare professionals, PWE, and their care-givers with the appropriate knowledge about SUDEP is very important to enable efficient preventive measures in PWE. In the current narrative review, following a brief discussion on the definition, epidemiology, and risk factors for SUDEP, the authors discuss the importance of appropriately educating healthcare professionals, PWE, and their caregivers about SUDEP.
Topics: Caregivers; Death, Sudden; Educational Status; Epilepsy; Humans; Risk Factors; Sudden Unexpected Death in Epilepsy
PubMed: 35623204
DOI: 10.1016/j.yebeh.2022.108742