Sudden cardiac death. Literature review. Part II. Sudden cardiac death in primary electrical heart disease and in certain groups of patients with increased risk of its development

The second part of the review is devoted to the problem of assessing the risk of sudden cardiac death, its primary and secondary prevention in patients with various variants of primary electrical heart disease (idiopathic ventricular fibrillation, long QT syndrome, Andersen-Tawil syndrome type I, Brugada syndrome, early ventricular repolarization syndrome, catecholaminergic polymorphic ventricular tachycardia, short QT syndrome). Considerable attention in this part of the review is paid to certain groups of patients who are at increased risk of developing sudden cardiac death. Such categories primarily include pregnant women, especially if they develop peripartum cardiomyopathy, patients with Wolff-Parkinson-White syndrome, patients requiring heart transplantation, and the elderly. The feasibility of genetic testing for various variants of primary electrical heart disease is considered. The approaches to pharmacological and surgical treatment of ventricular arrhythmias, which are the most common cause of sudden cardiac death, and their advantages in the indicated pathological conditions are discussed. Modern recommendations are given regarding indications for implantation of a cardioverter-defibrillator in the elderly. The problem of sudden cardiac death in athletes has become very relevant in recent years, which is also reflected in the presented review. It is shown that in middle-aged and older athletes, the most common cause of sudden cardiac death is chronic ischemic heart disease. The expediency of determining cardiovascular risk in all athletes before the start of intensive physical training, especially before participating in competitions, is emphasized. At the same time, it should be noted that the problem of sudden cardiac death requires further in-depth study in order to develop the most informative methods for predicting the development of this condition and effective primary prevention.