Sudden cardiac death in China: current status and future perspectives

Abstract

Sudden cardiac death (SCD) is a major cause of mortality worldwide. Similar to the number of SCDs in western countries including the USA, the number of SCDs in China is ∼544,000 annually. However, there are significant differences in patient characteristics between Chinese primary prevention population and U.S. primary prevention population. In contrast to western countries where implantable cardioverter-defibrillator (ICD) devices have been well adopted as a major effective method for both primary and secondary prevention of SCD, China has a low prevalence of ICD utilization (∼1.5 device per 1 million people). Socioeconomic and political factors, awareness and knowledge of SCD, and the difference in disease patterns have led to the underutilization of ICD in China. China, as the most populated and the second largest economic country in the world, has now taken variable approaches to address this pressing health problem and enhances the delivery of lifesaving therapies, including arrhythmia ablation and medical treatment besides ICD, to patients who are at risk of SCD.

Potential cost‐effectiveness of wearable cardioverter‐defibrillator for patients with implantable cardioverter‐defibrillator explant in a high‐income city of China

“…Sudden cardiac arrest (SCA) is often the first manifestation among patients with ventricular arrhythmias and the prevalence of annual SCA rate was 41.8 of 100 000 in China . It was estimated that SCA accounted for over 544 000 deaths among the 1.3 billion population of China . Defibrillation therapy is the only effective treatment for life‐threatening ventricular arrhythmias.…”

“…A prior US health economic evaluation found WCD to be cost‐effective from the societal perspective in patients with ICD explant . There is an increasing awareness of SCA in China and various approaches to deliver lifesaving therapy are being explored . WCD was approved for prevention of SCD in adult patients who are at risk of SCA with ICD removal or refusing ICD therapy by the National Medical Product Administration (formerly the China Food and Drug Administration) in 2016 and the first case of WCD usage for a patient with ICD explant in China was reported in 2018 .…”

“…1 It was estimated that SCA accounted for over 544 000 deaths among the 1.3 billion population of China. 2 Defibrillation therapy is the only effective treatment for life-threatening ventricular arrhythmias. The resuscitation is most successful if the defibrillation therapy is delivered within 5 minutes of collapse.…”

“…9 There is an increasing awareness of SCA in China and various approaches to deliver lifesaving therapy are being explored. 2 WCD was approved for prevention of SCD in adult patients who are at risk of SCA with ICD removal or refusing ICD therapy by the National Medical Product Administration (formerly the China Food and Drug Administration) in 2016 and the first case of WCD usage for a patient with ICD explant in China was reported in 2018. 10,11 The use of WCD is a potential intervention for timely delivery of defibrillation to prevent SCD, and the health economic impact of WCD in China is yet to be determined.…”

Overexpression of programmed cell death-1 on circulatory Th1 and Th2 cells in cardiac arrest patients in the early period after the return of spontaneous circulation

“…Cardiac arrest (CA) is the leading cause of morbidity and mortality of hospitalized patients globally and has low rates of overall survival (1). It is estimated that more than 544,000 deaths due to cardiac arrest occur annually in China (2). After the return of spontaneous circulation (ROSC), CA patients with systemic ischemia/reperfusion injury (IRI) can manifest 'sepsis-like' syndromes and immune disorders which can lead to infections (3)(4)(5).…”