New ACC/AHA report outlines 10 measures for the prevention of sudden cardiac death

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A new report from the American College of Cardiology and the American Heart Association presents 10 quality and performance measures that are intended to help stakeholders—including health systems, legislative bodies, and nongovernmental organisations, as well as healthcare practitioners, patients, families and communities—in the effort to prevent sudden cardiac death. The joint report has been published online in the Journal of the American College of Cardiology and Circulation: Cardiovascular Quality and Outcomes.

“This is the first comprehensive measure set in the area of sudden cardiac death prevention,” says Sana Al-Khatib, co-chair of the writing committee and professor of medicine at Duke University, Durham, USA. “Our vision is that these measures will be developed, tested, and implemented in clinical practice and that implementation will improve patient care and outcomes.

“While some people—such as patients with heart failure—are known to be at risk of sudden cardiac death, others are not. We need initiatives to improve the quality of care for those with a known risk, but also for the victims of sudden cardiac arrest.”

Although guidelines exist for the prevention of sudden cardiac death, there has been an underutilisation of public health initiatives, treatments and device therapies for at-risk patients, the report states. The writing committee attempted to identify performance measures that can assess the quality of care for the prevention of sudden cardiac death. Although sudden cardiac arrest and sudden cardiac death can affect people of all ages and demographics, the performance measures focus on adults. No limitations or restrictions for other demographics, such as sex, race/ethnicity, or socioeconomic status, were applied.

The performance measure set is intended to assist clinicians and help them provide better care for their patients at risk of sudden cardiac arrest and thereby to improve care and outcomes.

The reports’ performance and quality measures for the prevention of sudden cardiac death are as follows:

  • Smoking cessation intervention in patients who suffered sudden cardiac arrest, have a life-threatening ventricular arrhythmia, or are at risk for sudden cardiac death
  • Screening for family history of sudden cardiac death
  • Screening for asymptomatic left ventricular dysfunction among individuals who have a strong family history of cardiomyopathy and sudden cardiac death
  • Referring for cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) education those family members of patients who are hospitalised with known heart conditions that increase the risk of sudden cardiac arrest
  • Use of implantable cardioverter defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure and reduced ejection fraction who have an anticipated survival of more than one year
  • Use of guideline-directed medical therapy for prevention of sudden cardiac death in patients with heart failure and reduced ejection fraction
  • Use of guideline-directed medical therapy for prevention of sudden cardiac death in patients with heart attack and reduced ejection fraction
  • Documenting the absence of reversible causes of ventricular tachycardia/ventricular fibrillation cardiac arrest and/or sustained ventricular tachycardia before a secondary-prevention implantable cardioverter defibrillator is placed
  • Counselling eligible patients about implantable cardioverter defibrillators
  • Counselling first-degree relatives of survivors of sudden cardiac arrest associated with an inheritable condition about the need for screening for the inheritable condition