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Sudden death in idiopathic cardiomyopathy.

The incidence of sudden death in idiopathic cardiomyopathy was analyzed based on a multi-center study in Japan, and possible prevention was discussed. Among 540 cases reported from 15 institutions, sudden death was most frequent in congestive or dilated type (19 cases, 22% of 87 deaths) and the ratio of sudden death to all deaths was high in the hypertrophic nonobstructive type (7 cases, 54% of 13 deaths) or the hypertrophic obstructive type (5 cases, 45% of 11 deaths). In the latter 2 types, the occurrence of sudden death seemed to be more related to exercise than in the congestive type. In the analysis of 4 sudden deaths among patients in congestive type, sudden death occurred in relatively asymptomatic patients after recovery from acute congestive heart failure. For the effective prevention, detection of undiagnosed patients by electrocardiographic screening, education of patients to avoid unprepared exercise, evaluation of physical tolerance by exercise testing and need for official registration of victims were discussed.