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Medical Center Tower I 7950 Floyd Curl Drive Suite 803 San Antonio, TX 78229 tel: 210-615-9500 fax: 210-615-9600 email: office at cecst.com |
Specializing in the compassionate care of people who suffer from abnormalities of the electrical system of the heart |
Current Insurance Plans:
We accept most major commercial insurance plans. Please call for details. Medicare: We have opted out of Medicare, and are happy to care for Medicare beneficiaries on an affordable cash basis. Note: Federal law prohibits signing the Federally-mandated opt-out contract with a Medicare beneficiary who is in an emergency situation. No insurance? No problem! Consider our affordable Fee for service (direct pay). Home of the Original Personalized Medical Office SystemTM released April 5, 2013 |
| The Arrhythmias Section Contents |
| Sudden Cardiac Death |
| Sudden cardiac death is the end result of untreated rapid VT or ventricular fibrillation. It is the leading cause of death in the United States, affecting about 400,000 people each year and claiming the lives of about 70% of them. It occurs most often in people who have had heart attacks (myocardial infarction) in the past, but can occur in young people who were entirely well until they died. Most people who suffer sudden cardiac death can be saved if they are resuscitated promptly. The survivors are said to have "aborted sudden cardiac death." Their prognosis used to be dismal, with first-year recurrence rate (usually with fatality) ranging from 20 to 40%. Now that implantable cardioverter-defibrillator (ICD) therapy is available, however, the first year recurrence rate is only 1 to 2%. Until recently, there has been a controversy as to whether drugs can work as well as the ICD. On April 7, 1997, however, the question appeared to be settled by a large clinical trial, the Amiodarone Versus Implantable Defibrillator (AVID) trial. Despite flaws in its design that biased it in favor of not finding a difference between amiodarone (a drug) and the ICD, the study was stopped prematurely because it showed that patients who received ICD devices had a much lower mortality than those treated with amiodarone or sotalol (another antiarrhythmic drug). For those patients who cannot receive an ICD, however, amiodarone is an excellent treatment choice. Sotalol is also good when its efficacy is proven with appropriate testing. Based on the best available data, however, the ICD device is the most effective treatment. ICDs may also prove to be the most cost-effective when the data are analyzed. Available data suggest that the cost per year of life saved is about $30,000 to $35,000, which is less than the costs of other, well-established therapies such as those for high cholesterol. |
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