Causes of nonischemic sudden cardiac death in the current era

A Clinical Perspective on Sudden Cardiac Death

“…30 The most common causes of non-ischaemic SCD are currently cardiomyopathy related to obesity or alcoholism and fibrotic cardiomyopathy. 31 In patients with preserved ejection fraction in the Cardiac Arrest Survivors with Preserved Ejection Fraction Registry (CASPER), an aetiological diagnosis was possible in approximately half of cardiac arrest survivors, the rest being considered cases of idiopathic ventricular fibrillation (VF), presumably due to intrinsic electric abnormalities such as early repolarisation. 32 A resuscitated cardiac arrest victim, preferably with documentation of VF, in whom known cardiac, respiratory, metabolic and toxicological aetiologies have been excluded through clinical evaluation is considered to have idiopathic VF.…”

Temporal Trends in the Clinical and Pathological Characteristics of Victims of Sudden Cardiac Death in the Absence of Previously Identified Heart Disease

“…The study started in 1998, and the design has been previously reported in detail. [16][17][18][19] The study population consists of prospective accumulation of (n=4031; without previous heart disease n=2697) consecutive white victims of SCD in the Province of Oulu, Northern Finland, on whom postmortem examinations were performed at the Department of Forensic Medicine of the University of Oulu between 1998 and 2012. The sudden death autopsy rate in Finland is the highest in Western societies.…”

“…20,21 Postmortem studies are mandatory in Finland whenever sudden death cannot be attributed to a known disease, the deceased has not been treated by a physician during his/her last illness, or when death has otherwise been unexpected (Act on the Inquest into the Cause of Death, 459/1973, 7th paragraph: Finnish Law). [19][20][21] The determination of the cause of death and information about the medical history including drug therapy of the victims of SCD were based on a combination of death certificates, medical records, autopsy data, and the result of a standardized questionnaire completed by the closest family members of the victims of sudden death. [16][17][18][19] The data were collected prospectively and stored at the coordinating center of the Medical Research Center Oulu, University of Oulu.…”

Alcohol and Heart Rhythm Disorders

“…Сложные эфиры жирных кислот, об-разующиеся из этанола при ферментативной реакции со свободными жирными кислотами, и ацетальде-гид, возможно, играют ключевую роль в развитии диффузной миокардиальной гипокинезии. Регулярное злоупотребление алкоголем приводит к развитию ал-когольной кардиомиопатии (АКМП), являющейся при-чиной 1/5 всех случаев внезапной сердечной смерти [15]. Электронно-микроскопические исследования при длительном воздействии этанола и его метаболи-тов на миокард выявляют:…”