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ARRHYTHMIA, sudden early death and prevention for relatives

A cautionary not from the SKEPTICS.  With corporate medicine profits are the measure of treatment.  Arrhythmia is not an exception.  There are extreme cases where intervention is life-prolonging, but in most cases the harm is greater than the benefit.  More articles will be appearing on this topic shortly.  

12 out of 17 families had arrhythmia as the cause of death.  Recommendation that for families with sudden, early cardiac deaths, relatives should be tested. 


Circulation published by American Heart Association


Published online before print July 5, 2005, doi:10.1161/CIRCULATIONAHA.104.522581







Circulation. 2005;112:207-213.)
2005 American Heart Association, Inc.



Sudden Unexplained Death


Heritability and Diagnostic Yield of Cardiological and Genetic Examination in Surviving Relatives

Hanno L. Tan, MD, PhD; Nynke Hofman, BSc; Irene M. van Langen, MD; Allard C. van der Wal, MD, PhD; Arthur A.M. Wilde, MD, PhD

From the Departments of Cardiology (H.L.T., A.A.M.W.), Clinical Genetics (N.H., I.M.v.L.), and Pathology (A.C.v.d.W.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Correspondence to Arthur A.M. Wilde, MD, PhD, Academic Medical Center, University of Amsterdam, Department of Cardiology, M0–105, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. E-mail

Received November 18, 2004; revision received March 24, 2005; accepted April 4, 2005.

Background— Sudden death mostly follows from cardiac disorders that elicit lethal ventricular arrhythmias. In young individuals, it often remains unexplained because history and/or postmortem analysis are absent or provide no clue. Because such sudden unexplained deaths (SUDs) may have heritable causes, cardiological and genetic assessment of surviving relatives of SUD victims may reveal the underlying disease and unmask presymptomatic carriers. We aimed to establish the diagnostic yield of such assessments.

Methods and Results— We investigated 43 consecutive families with 1 SUD victim who died at 40 years of age. All studied relatives underwent resting/exercise ECG and Doppler echocardiography. Molecular genetic analysis was conducted to confirm the diagnosis. We identified an inherited disease and likely cause of death in 17 of 43 families (40%). Twelve families had primary electrical disease: catecholaminergic polymorphic ventricular tachycardia (5 families), long-QT syndrome (4 families), Brugada syndrome (2 families), and long-QT/Brugada syndrome (1 family). Furthermore, we found arrhythmogenic right ventricular cardiomyopathy (3 families), hypertrophic cardiomyopathy (1 family), and familial hypercholesterolemia (1 family). Molecular genetic analysis provided confirmation in 10 families. Finding the diagnosis was more likely when more relatives were examined and in families with 2 SUD victims 40 years of age. The resting/exercise ECG had a high diagnostic yield. These efforts unmasked 151 presymptomatic disease carriers (8.9 per family).

Conclusions— Examination of relatives of young SUD victims has a high diagnostic yield, with identification of the disease in 40% of families and 8.9 presymptomatic carriers per family. Simple procedures (examining many relatives) and routine tests (resting/exercise ECG) constitute excellent diagnostic strategies. Molecular genetics provide strong supportive information.

Key Words: arrhythmia • death, sudden • genetics • long-QT syndrome • tachyarrhythmias



Comments by Dr. Wilde in an interview:  Of the 333 first- and second-degree relatives tested, 151 had the same previously unrecognized and potentially fatal heart abnormality as their dead family member. That works out to an average of 8.9 people in each family. Of those 151 people, 138 had mutated genes known to predispose people to early death, the study found.

"Based on our findings, we strongly advise that first-degree relatives (immediate family members) and second-degree relatives (grandparents, aunts and uncles) be referred to a cardiologist for testing," Wilde said.

"Most of the diseases we identified in our study are not only amenable to treatment, but if treated correctly, are also associated with a virtually normal life expectancy," he added.

Sudden Cardiac Death Spells Heart Trouble in Family
Dying at young age means relatives should be tested for heart defects, study says

by Robert Preidt | Jul 05 '05 Sudden Cardiac Death Spells Heart Trouble in Family
Dying at young age means relatives should be tested for heart defects, study says

by Robert Preidt | Jul 05 '05, HealthyDay


Other interesting facts:  Men with a high resting heart rate, more than 75 beats per minute, were nearly 3 1/2 times as likely to die suddenly from a heart attack as those with fewer than 60 beats per minute, according to a study in last week's New England Journal of Medicine. The study, which followed French men for more than 20 years, also showed that those whose heart rates shot up higher during exercise and decreased quickly upon stopping were less likely to die from a sudden heart attack. That profile, says Tim Church, who has done similar research at the Cooper Institute in Texas, is typical of someone in good shape. Heart rate can often be improved with exercise. Researchers say they do not know if a similar result would be found in women.


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Those who have a financial interest in the outcome manipulate the results, Major study finds that all 37 journal articles positive effects over stated; the average was 32%. Statins cause erectile dysfunction, cognitive imparement, and cancer.  

Lipitor (2011) lifetime sales $131 billion, tops all drugs.  Plavix at $60 billion is second.



52% short term


LA Times, Health section, July 21, 2008  --  excerpts

Vytorin, the combination drug (simvastatin (better known by its commercial name Zocor) and ezetimibe--known as Zetia) prescribed to lower cholesterol, sustained another blow today, when the author of a major clinical trial announced that the medication had failed to drive down hospitalization and death due to heart failure in patients with narrowing of the aortic valve. In the process, researchers in Norway detected a significant blip in cancers in the 1,800 subjects they followed

Today's findings suggested something more ominous: the incidence of cancer -- and of dying of cancer -- was significantly higher in the patients taking Vytorin. Altogether, 67 patients on placebo developed cancer during the trial. Among subjects on Vytorin, 102 developed cancers of various kinds.*  This is the second adverse press—the first being in March 08, when the ENHANCE trial found that Vytorin fared no better than a placebo at reducing plaque buildup on the walls of patients' arteries.* *

Comments by jk

Simvastatin (Zocor) is off patent.  Thus in a scramble for profits a combination drug (on patent) was introduced.  Direct to consumer market cost $155 in 07—mainly TV ads. 

*  The pressing issue is that since the development  of Statins, the very first animal studies in the 60s it has been known that Statins increase the incidents of cancer.  However, nearly all studies done thereafter have not included cancer. 

*  Several studies have failed to find a reduction in the build of plaque, even thought the statins including Zocor, reduce LDL and cholesterol.  Few studies include the principle reason for taking a statin, namely a reduction in the death rate.  Claims for such reduction probably entail a failure to control the contravening variable, aspirin usage.  Given a pile of evidence, including the very mechanism of plaque formation, which involves inflammation process, I must conclude that the use of statins is highly suspect.  Given the harm done including cognitive impairment, weakness, and cancer, if my skepticism is born out, the harm done by statins as a course of treatment will far surpass that of VIOXX which killed over 200,000 people world wide by accelerating atherosclerosis.