Sudden cardiac death is one of the leading causes of death in the United
States, accounting for an estimate 350,000 deaths
each year. The US Congress
passed a resolution in late September 2008 designating October as “National Sudden Cardiac Arrest Awareness Month.” In an effort to raise awareness for
preventing unnecessary deaths because of sudden cardiac
death, the resolution “calls upon the people of the United States to observe
this month with appropriate programs and activities.” The response from our
institute was to develop a novel pathway named ESCAPE—which is an evidence-based
novel pathway for low Ejection fraction and Sudden Cardiac death Awareness and
Prevention Eligibility. The main objective of this program is to demonstrate
that implementing a simple novel pathway for primary prevention of sudden
cardiac arrest leads to an increase in the number of patients with low ejection
fraction ( 35%) referred for implantable cardioverter defibrillators therapy.
The key difference of our pathway compared with prior reported algorithms is
that it is initiated at imaging laboratories. The registry will consist of
consecutive patients presenting to our imaging laboratories (the
echocardiography, the nuclear, and the cardiac catheterization laboratories).
The ESCAPE pathway defines patients’ management based upon 3 key parameters:
left ventricular ejection function, heart failure functional class, and an
evidence of a prior myocardial infarction or coronary artery disease. We hope
that this new novel pathway will help to bridge the gap between the complex
guidelines and the actual clinical practice and will help to save many lives.