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Book and Media Reviews
October 20, 2010

Clinical Approach to Sudden Cardiac Death Syndromes

JAMA. 2010;304(15):1724-1725. doi:10.1001/jama.2010.1523

Prevention of sudden cardiac death (SCD) is an important issue in clinical practice. Despite reductions in age-adjusted death rates in patients with cardiovascular disease over the past 20 years, approximately 325 000 deaths still occur suddenly and unexpectedly each year. In 20% to 30% of cases, SCD—commonly defined as death within 1 hour after onset of symptoms—occurs without warning. It is generally assumed that this mode of death is attributable mainly to ventricular tachycardia and fibrillation, although this event can be difficult to document, an inherent limitation in SCD studies. The 5-part Clinical Approach to Sudden Cardiac Death Syndromes, edited by Ramon Brugada, Josep Brugada, and Pedro Brugada, represents an attempt to demonstrate the clinical physiological and genetic complexity of this public health problem and the need to provide a compelling rationale for development of noninvasive markers to stratify risk for life-threatening arrhythmias and to guide preventive pharmacologic therapy. The book addresses the main guidelines for diagnosis, prevention, and risk stratification of SCD. It describes the most frequent genetic syndromes associated with SCD and discusses how clinicians might decide on the most appropriate clinical tests. It details the approach to patients and family members with an inherited disease who are at high risk of sudden death, and also covers the ethical, legal, and social implications of SCD in Western culture.