Robert J. Myerburg, Kenneth M. Kessler, Agustin Castellanos

To integrate information from the various disciplines that contribute to the understanding of the cause and prevention of sudden cardiac death: identification of new approaches from applied clinical epidemiology; identification and control of transient risk factors; and evaluation of the results of interventions. A broad range of research reports and interpretations of data from English-language journal articles and reviews, published primarily between 1970 and 1993. The fields of study included epidemiology, experimental electrophysiology, clinical observations, and interventions. Continuous literature surveys, done in relation to ongoing clinical and experimental research on sudden cardiac death since 1972. Included on the basis of relevance to the topics discussed and with confirmation of data and concepts by more than one investigator when available. Information from several disciplines was integrated by the authors to synthesize new ways to view the problem of sudden cardiac death. Quantitative information was used primarily to derive qualitative statements about new perspectives on sudden cardiac death. Progress in the prevention of sudden death will require development of new approaches, including epidemiologic techniques to address risk characteristics specific to the problem; characterization of triggering events and identification of specific persons at risk for responding adversely to these events; and methods of evaluating outcomes appropriate to the nature of sudden cardiac death.