Drugs, QTc prolongation and sudden cardiac death

__Abstract__ The term sudden cardiac death pertains to an unexpected death from cardiac causes within a short time period and has been described throughout history. The ancient Egyptians inscribed on the tomb of a nobleman some 4500 years ago that he had died suddenly and without apparent cause. Another early case of sudden death was Phidippides, the young Greek messenger, who collapsed and died after he ran 26.2 miles from Marathon to Athens to deliver the news of the Greek victory over the Persians in 460 BC. It has been hypothesised that Hippocrates in his writings provided the first medical description (approximately 400 BC) of sudden cardiac death: "Those who are subject to frequent and severe fainting attacks without obvious cause die suddenly". Sudden (cardiac) death was originally ascribed to supernatural causes. In the bible Ananias and his wife Sapphira were punished for their deceit by sudden death "WhenAnanias heard this, he fell down and died. And great fear seized all who heard what had happened. About three hours later his wife came in, not knowing what had happened. Peter asked her, "Tell me, is this the price you and Ananias got for the land?" "Yes," she said, "that is the price." Peter said to her, "How could you agree to test the Spirit of the Lord? Look! 1he feet of the men who buried your husband are at the door, and they will carry you out also. " At that moment she fell down at his feet and died. 1hen the young men came in and, .finding her dead, carried her out and buried her beside her husband. (ACTS 4:32-5:II). Even when medical science advanced to a stage where autopsies became available many sudden cardiac deaths remained unexplained. Only recently, it has been hypothesized that Napoleon might have died due cardiac arrhythmias induced by drugs the Emperor was using at that time.

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