Neural and Psychologic Factors in Sudden Death
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No problem looms larger in contemporary cardiology than that of containing sudden death. In the United States this one condition claims annually about 450,000 victims or nearly one each minute around the clock. Such death is not the end stage of irreversible coronary artery atherosclerosis nor is it the consequence of coronary thrombosis, or acute myocardial infarction. It is the result of a cardiac electrical accident which is both reversible and preventable (1). To identify and protect the subject at risk must be high on the agenda of medical attention and research preoccupation. If effective clinical strategies are to be evolved, there must be clarity as to the precipitants of the electrical accident. It is our view that transient risk factors catapult the electrically unstable heart into repetitive and disorganized rhythmic activity. Inputs from higher nervous centers are among the major transient risk factors.
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