The evolving science on sudden cardiac death—the marriage of left ventricular hypertrophy and QT-dispersion

Abstract

The first description of sudden cardiac death was made by Hippocrates in the 4‘th century BC1. Such cases of sudden collapse and death has intrigued both the public and medical science for centuries and a practical definition is that sudden cardiac death is the unexpected and natural death from a cardiac cause within a short period of time, usually less than 1 hour from the onset of symptoms, in a person without any known prior condition1,2. Sudden cardiac death (SCD) is clearly the end-result of a wide variety of cardiac conditions—both congenital and acquired. However, the most common mechanism for the event of SCD is ventricular fibrillation1. However this is an evolving field of study and the recent study published by Stojanovic et al3 is of great importance as it links two well known risk factors for SCD—left ventricular hypertrophy (LVH) and QT-dispersion4. The finding by Stojanovic et al3 that septal thickness in both athletes and sedentary men are associated with increased QTd is concerning and future studies need to clarify if we need to keep the septum thin at all costs with more exercise for some and less for others.