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April 19, 1965

Sudden Cardiac Death

JAMA. 1965;192(3):266. doi:10.1001/jama.1965.03080160086044

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Thirty-three outstanding authorities reviewed the mechanisms responsible for sudden (nonviolent) death and presented new information from the electro-physiological, anatomic, and clinical standpoints.

The overwhelming majority of patients who die suddenly have diffuse coronary artery disease. Angiography demonstrates it with clarity during life. At the University Hospitals, Cleveland, terminal electrocardiograms recording the precise moment the heart stopped beating effectively were available from 113 patients. This study demonstrated two mechanisms of death. Primary "power failure," characterized by myocardial failure, hypotension, and shock, was responsible for death in 42%; "electrical failure," characterized by disturbances of the cardiac mechanism and arrhythmias, was responsible in 40%. A combination of both was responsible in 18%.

According to Pick, antiarrhythmic drugs, such as quinidine, help ventricular fibrillation incident to premature beats. Scherf maintains that "quinidine is indicated in all patients with myocardial infarction who have ectopic rhythms, with two exceptions... heart block... and.

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