Download Take the EF and SCA Challenge!

Take the EF and SCA Challenge!
Current medical research and guidelines are focusing more attention on ejection fraction
as a way to help heart patients and their clinicians make better decisions about their care,
particularly heart patients who may be at risk for sudden cardiac arrest (SCA).
Test your knowledge about ejection fraction and sudden cardiac arrest.
You may be surprised by what you know (or don’t know)!
1. Q: According to the Sudden Cardiac
Death in Heart Failure Trial (SCDHeFT), NYHA Class II and III heart
failure patients with what EF %
are at significant risk for sudden
cardiac death?
A:
a. 50% or less
b. 40% or less
c. 35% or less
d. 15% or less
2. Q: There are approximately five
million patients with congestive
heart failure in the US2 How
much more likely are heart
failure patients than the general
population to have a sudden
cardiac arrest?
A:
a. 1-2 times
b. 4-5 times
c. 6-9 times
d. 10-15 times
3. Q: What percent of patients who have
had a heart attack and have had an
echo know their ejection fraction
number?
A:
a. 5%
b. 20%
c. 45%
d. 75%
4. Q: What is the percent of people who
have a sudden cardiac arrest in the
US and die?
A:
a. 1%
b. 5%
c. 50%
d. 95%
5. Q: What % of patients with an ICD
survive a sudden cardiac arrest?
A:
a. 50%
b. 25%
c. 79%
d. 98%
200701430EN_Q&A.indd 1
6. Q: Of 1,000 Class II/III, low EF (35%
and less) heart failure patients,
how many are likely to die over a
5-year period without access to
defibrillation (external or internal)?
A:
a. 22
b. 72
c. 250
d. 553
7. Q: Out of 1,000 heart failure patients,
what percent will be NYHA Class II
and III with an EF ≤ 35%?
A:
a. 5%
b. 13%
c. 32%
d. 51%
8. Q: Sudden cardiac death is responsible
for a significant number of deaths in
the US24, more than stroke, breast
cancer and HIV/AIDS combined.
How many people die from sudden
cardiac death each year?
A:
a. 150,000
b. 335,000
c. 525,000
d. 1,500,000
9. Q: 80% of all people who die from
sudden cardiac death show
evidence of what?
A:
a. Previous coronary artery
bypass surgery
b. Coronary heart disease
c. Congestive heart failure
d. Family history of sudden
cardiac death
10. Q: A heart patient with which of the
following characteristics is at risk
for sudden cardiac death?
A:
a. Coronary artery bypass
b. Myocardial infarction
c. Heart failure
d. Blood relative who has
had an SCA
e. All of the above
11. Q: What fraction of Class II HF
patients die from SCD?
A:
a. 2/3
b. 1/2
c. 1/4
d. 3/4
12. Q: What percent is considered a
LOW ejection fraction?
A:
a. 75%
b. 65%
c. 50%
d. 35%
13. Q: What percent of patients who
are indicated for an ICD actually
receive one?
A:
a. 5%
b. 10%
c. 20%
d. 80%
14. Q: What is the single most important
risk factor for overall mortality and
sudden cardiac death?
A:
a. Blood relative dying
suddenly
b. Previous heart attack
c. Reduced LVEF
d. Valvular disease
15. Q: In the 2005 ACC/AHA Heart Failure
Guidelines, ICD therapy is a Class I
indication for which patient?
A:
a. Survivors of VT/VF
b. Previous MI and EF ≤ 35%
c. NYHA Class II or III and EF
≤ 35%
d. All of the above
Answers on back
10/16/06 2:23:08 PM
Answers
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
c. 35% or less1
c. 6-9 times2
a. 5%3
d. 95%4-6
d. 98%7
b. 72 heart failure patients1
c. 32%8-11
b. 335,000 die each year from SCD in the US2
b. Coronary heart disease12,13
e. All of the above are risk factors for SCD14-17
a. 2/3 of all Class II HF patients die from sudden cardiac death18
d. For many clinicians, a person with an EF of 35% or less is considered low1
c. 20%19-21
c. Reduced LVEF22
d. All of the above23
References
1
Bardy GH, Lee KL, Mark DB, et al, for the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart
failure. N Engl J Med. January 20, 2005;352(3):225-237.
2
American Heart Association. Heart Disease and Stroke Statistics – 2005 Update.
3
Medtronic data on file.
4
American Heart Association. Statistical fact sheet. “Sudden deaths from cardiac arrest.” Accessed via the Internet on Aug. 1, 2006 at http://www.americanheart.org/presenter.jhtml?identifier=3008699.
5
Pell JP, Sirel JM, Marsden AK, Ford I, Walker NL, Cobbe SM. Presentation, management, and outcome of out of hospital cardiopulmonary arrest: comparison by underlying aetiology. Heart.
August 2003;89(8):839-842.
6
de Vreede-Swagemakers JJ, Gorgels AP, Dubois-Arbouw WI, et al. Out-of-hospital cardiac arrest in the 1990s: a population-based study in the Maastricht area on incidence, characteristics and
survival. J Am Coll Cardiol. November 15,1997;30(6):1500-1505.
7
Zipes DP, Roberts D. Results of the international study of the implantable cardioverter-defibrillator. A comparison of epicardial and endocardial lead systems. The Pacemaker-Cardioverter
Defibrillator Investigators. Circulation. July 1, 1995;92(1):59-65.
8
Senni M, Tribouilloy CJ, Rodeheffer RJ, et al. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991. Circulation. November 24, 1998;98(21):
2282-2289.
9
Vasan RS, Larson MG, Benjamin EJ, Evans JC, Reiss CK, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a
population-based cohort. J Am Coll Cardiol. June 1999;33(7):1948-1955.
10
Cowie MR, Wood DA, Coats AJ, et al. Incidence and aetiology of heart failure; a population-based study. Euro Heart J. March 1999;20(6):421-428.
11
Havranek EP, Masoudi FA, Westfall KA, Wolfe P, Ordin DL, Krumholz HM. Spectrum of heart failure in older patients: results from the National Heart Failure project. Am Heart J. March 2002;143(3):412-417.
12
Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N Engl J Med. November 15, 2001;345(20):1473-1482.
13
Myerburg RJ. Heart Disease, A Textbook of Cardiovascular Medicine. 6th ed. W.B. Saunders Co., 2001.
14
Demirovic J, Myerburg RJ. Epidemiology of sudden coronary death: an overview. Prog Cardiovasc Dis. July-August 1994;37(1):39-48.
15
Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. March 21, 2002;346(12):877-883.
16
A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators
AVID) Investigators. N Engl J Med. November 27, 1997;337(22):1576-1583.
17
Friedlander Y, Siscovick DS, Weinmann S, et al. Family history as a risk factor for primary cardiac arrest. Circulation. January 20, 1998;97(2):155-160.
18
Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. June 12, 1999;353(9169):2001-2007.
19
Ruskin JN, Camm AJ, Zipes DP, et al. J Cardiovasc Electrophysiol. 2002;13(1):38-43.
20
Medtronic internal estimate based on device registration data.
21
Weighted average of Class I and Class IIa penetration estimates.
22
Priori SG, Aliot E, Blomstrom-Lundquist C, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J. August 2001;22(16):1374-1450.
23
ACC/AHA 2005 Guidelines Update for the Diagnosis and Management of Chronic Heart Failure in the Adult.
24
Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989 to 1998. Circulation. 2002;104(18):2158-2163.
World Headquarters
Medtronic, Inc.
710 Medtronic Parkway
Minneapolis, MN 55432-5604
USA
Tel: (763) 514-4000
Fax: (763) 514-4879
www.medtronic.com
Medtronic USA, Inc.
Toll-free: 1 (800) 328-2518
(24-hour technical support for
physicians and medical professionals)
200701430EN_Q&A.indd 2
UC200701430 EN
© Medtronic, Inc. 2006
All Rights Reserved
Printed in USA
October 2006
10/16/06 2:23:09 PM