Revascularization as a means of reducing sudden death.

From this brief overview the arguments have become clear why further studies are needed to verify that the problem of unnecessary sudden cardiac death can best be tackled by a strategy aimed at early and complete revascularization. Whether such a strategy begins with intravenous injection of rt-PA at home or requires subsequent intracoronary manipulation when obstruction persists, whether by thrombolysis with other agents, PTCA or bypass surgery, is in itself a moot point. The main aim should be to offer this strategy as the best chance to reduce the unnecessary sudden death rate which presently accounts for between 25 and 50% of all cardiac deaths. This approach deserves consideration particularly since earlier approaches employing cardioprotective efforts by beta blockade or by anti arrhythmic agents have patently shown that they cannot tackle the problem in a convincing manner.