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43.10 Prevention of sudden cardiac death in the general population
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Published:July 2018
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Abstract
Primary prevention of sudden cardiac death (SCD) aims at averting the first manifestation of a life-threating arrhythmic event. The first step towards primary prevention is the identification of individuals with a higher risk for SCD within a certain population by screening methods. In the case of the general population, risk stratification and thus primary prevention of SCD remains challenging. Several markers have been evaluated as screening methods for SCD in the general population including risk factors for atherosclerosis, genetic factors, electrocardiographic findings, biomarkers, imaging techniques, and other diagnostic methods. However, none of those methods has hitherto proved of sufficiently high diagnostic accuracy, cost-effectiveness, and impact on SCD incidence and prognosis to justify its use for mass screening. Thus, broad population screening for SCD or primary prevention interventions in the general population are not recommended by current guidelines. In anticipation of further evidence, screening for SCD is confined to certain parts of the general population with a relatively increased risk for SCD, including athletes and individuals with a family history of SCD or an accumulation of risk factors for atherosclerosis. The basic risk assessment in those individuals include detailed personal and family history taking, clinical examination, and resting 12-lead electrocardiogram, while further diagnostic tests may be required in case of abnormal findings during the basic assessment.
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