Sudden Cardiac Arrest

Treatment

Preventive Treatment

Treatments used to prevent a sudden cardiac arrest episode vary, based on the patient's medical condition and underlying risk factors. Mayo Clinic doctors do extensive diagnostic and genetic testing, when appropriate, to identify the cause of life-threatening abnormal heart rhythms (arrhythmias) that put patients at risk for sudden cardiac arrest.

Mayo Clinic's team of heart specialists work together to aggressively control sudden cardiac arrest risk factors and develop a unique treatment plan for each patient. Treatment may include medical devices, surgery and other procedures, and medications.

Implantable cardioverter defibrillator

Arrhythmias can be treated with a small medical device called an implantable cardioverter defibrillator (ICD). ICDs are implanted under the skin below the collarbone and attached to a plastic-coated wire in the heart to continually monitor heart rhythms. They restore normal rhythms by pacing the heart or delivering a burst of electrical energy when an abnormal rhythm is detected.

Mayo Clinic's Heart Rhythm Clinic includes a sub-clinic, the Implantable Device Clinic, for patients who require ICDs and other similar devices. Annually, Mayo's heart specialists implant defibrillators in more than 600 patients and monitor follow-up care for more than 15,000 ICD patients.

Corrective heart surgery

The type of surgery or procedure that may be recommended to prevent sudden cardiac death depends on the underlying condition or disorder that is causing the arrhythmia.

Heart surgery may be recommended for patients with a congenital heart defect, congestive heart failure, heart valve malfunction or heart muscle disease due to cardiomyopathy. These surgeries can improve irregular, abnormal heart rates and blood flow throughout the heart.

Angioplasty is a procedure that opens blocked arteries (blood vessels) to allow blood to flow more smoothly to the heart. During this procedure, a long, thin tube (catheter) is threaded through an artery in the leg to arteries in the heart. When the tube reaches a blocked artery, a small balloon expands in the artery to push open the blockage. To keep the artery open permanently, the cardiologist may insert a small metal coil (stent) inside the artery.

For more than 50 years, Mayo Clinic has been a leader in developing new catheter-based treatment techniques for patients with heart problems.

Beta-blockers

Beta-blockers are a class of heart medications prescribed to treat arrhythmias. They prevent abnormally fast or irregular rhythms that can lead to sudden cardiac arrest.

Treatment After Sudden Cardiac Arrest

Patients who have survived a sudden cardiac arrest episode are at high risk for experiencing another episode. When medications and heart-healthy lifestyle changes cannot relieve arrhythmias, corrective heart surgery and other procedures also are recommended.

Implantable cardioverter defibrillator

Implantable cardioverter defibrillators (ICDs) greatly reduce the chances of dying from a second episode of sudden cardiac arrest by monitoring and controlling abnormal heart rhythms.

Corrective heart surgery

The types of surgery that may be required to prevent future sudden cardiac arrest episodes vary, depending on the underlying cause of sudden cardiac arrest in the patient.

Surgery to improve or correct arrhythmias may be recommended for patients with a congenital heart defect, congestive heart failure, heart valve malfunction or heart muscle disease due to cardiomyopathy.

Some surgical procedures that may be recommended include bypass surgery, heart transplant, cardiac catheter ablation, alcohol septal ablation, and myectomy.

• Myectomy — Myectomy is an open-heart surgery to remove a portion of overgrown heart muscle that obstructs blood flow to the heart. The procedure provides symptom relief for patients with hypertrophic cardiomyopathy. More than 1,000 myectomy surgeries have been performed at Mayo Clinic since 1960.
• Left cardiac sympathetic denervation surgery — Left cardiac sympathetic denervation surgery (LCSD) is a procedure that is paired with video-assisted thoracic (chest) surgery (VATS) to treat patients with high-risk hereditary heart rhythm problems such as long QT syndrome. The procedure is often recommended for patients who have already received lifesaving ICD treatment or are not helped by medications. Mayo Clinic is one of the most experienced centers in the world in performing VATS-LCSD surgery.
• Angioplasty and stents — Angioplasty is a procedure to open blocked arteries (blood vessels) using a flexible tube (catheter) and allow blood to flow more smoothly to the heart. A balloon at the end of the catheter is inflated to widen the blocked artery, and a metal coil (stent) is inserted in the artery to keep it open permanently.
• Cardiac catheter ablation — Catheter ablation is a minimally invasive procedure that does not require open-heart surgery. The procedure is done using catheters to access the heart and destroy abnormal heart tissue. In the U.S., Mayo Clinic is a leader in catheter ablation and has performed more than 800 ablations in patients with heart arrhythmias since 1998.

Medications

Anti-arrhythmia medications such as beta-blockers may be given to decrease how often a patient experiences irregular heart rhythms.