It is most dangerous cardiac arrhythmia as it produces suddern death. Sudden cardiac death is defined as non-traumatic
unexpected death in clinically stable and well patients who die within one hour after the onset of symptoms Causes
1. Ischaemic heart disease particularly during acute myocardial infarction
2. Drugs-Digitalis, Quinidine, Adrenaline, PhenonthiazinesCyclopropane anaesthesia, Bretylium
3. Hypothermia.
4. Rheumatic Myocarditis
5. Cardiac operations
6. Any anoxic condition
7. Electrolyte imbalance like hypo- and hyperkalaemia and hypercalcaemia.
8. Electrocution.
9. Rarely in association with complete AV block, long QT
syndrome etc
10. Non-ischaemic cardiomyopathy and infiltration diseases
11. Infectious diseases like viral myocarditis, Chagas disease
lyme disease.
12. Congenital cardiac defects such as hypertrophic cardio-
myopathy, arrhythmogenic right ventricular dysplasia.
13. Inflammatory diseases affecting myocardium SLE
Rheumatoid arthritis
14. Surgical repair of congenital heart disease
15. Cardiac malignancy-primary and secondary
16. Aortic stenosis, pulmonary stenosis, primary pulmonary
17.Congenital cyanotic heart disease.
18. Mitral valve prolapse.
19. Cardiac conduction defects.
Clinically pulse and heart sounds are absent and patient develops shock with rapid coma. Stokes Adams attack may
also develop.Treatment Use of defibrillators under DC counter shock is the treatmentof choice. When facilities are not available external cardiacmassage with mouth to mouth breathing should be done

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