A new report released by the ACC and the American Heart Association presents 10 quality and performance measures that are intended to help stakeholders – including health systems, legislative bodies, and nongovernmental organizations, as well as health care practitioners, patients, families and communities – in the effort to prevent sudden cardiac death (SCD). The joint report was published Dec. 19 in the Journal of the American College of Cardiology and Circulation: Cardiovascular Quality and Outcomes.

In the U.S., approximately 356,500 out-of-hospital cardiac arrests occur each year. Many of the sudden deaths occurring in the U.S. may be prevented by implementing evidence-based and guideline-endorsed recommendations for primary or secondary prevention of SCD. Although guidelines exist for the prevention of SCD, there has been an underutilization of public health initiatives, treatments and device therapies for at-risk patients. The writing committee attempted to identify performance measures that can assess the quality of care for the prevention of SCD. The performance measure set is intended to assist clinicians and help them provide better care for their patients at risk of sudden cardiac arrest and thereby to improve care and outcomes.

The 10 quality and performance measures are:

• Smoking cessation intervention in patients who suffered sudden cardiac arrest, have a life-threatening ventricular arrhythmia, or are at risk for SCD
• Screening for family history of SCD
• Screening for asymptomatic left ventricular dysfunction among individuals who have a strong family history of cardiomyopathy and SCD
• Referring for CPR and AED education those family members of patients who are hospitalized with known heart conditions that increase the risk of sudden cardiac arrest
• Use of implantable cardioverter defibrillators (ICDs) for prevention of SCD in patients with heart failure and reduced ejection fraction who have an anticipated survival of more than one year
• Use of guideline-directed medical therapy for prevention of SCD in patients with heart failure and reduced ejection fraction
• Use of guideline-directed medical therapy for prevention of SCD in patients with heart attack and reduced ejection fraction
• Documenting the absence of reversible causes of ventricular tachycardia/ventricular fibrillation cardiac arrest and/or sustained ventricular tachycardia before a secondary-prevention ICD is placed
• Counseling eligible patients about an ICD
• Counseling first-degree relatives of survivors of sudden cardiac arrest associated with an inheritable condition about the need for screening for the inheritable condition  

“This is the first comprehensive measure set in the area of SCD prevention,” said Sana Al-Khatib, MD, FACC, co-chair of the writing committee. “Our vision is that these measures will be developed, tested, and implemented in clinical practice and that implementation will improve patient care and outcomes.”

Keywords: American Heart Association, Cardiomyopathies, Cardiopulmonary Resuscitation, Counseling, Death, Sudden, Cardiac, Defibrillators, Implantable, Heart Failure, Myocardial Infarction, Out-of-Hospital Cardiac Arrest, Patient Care, Public Health, Quality of Health Care, Secondary Prevention, Smoking Cessation, Survivors, Tachycardia, Ventricular, Ventricular Dysfunction, Left, Ventricular Fibrillation, Cardiology Magazine, ACC Publications