oa “From Qatar to the World” Abstracts Presented at International Conferences /or Published in Medical Journals

Heart failure (HF) is a major killer. Many die due to uncontrolled HF, but many die even when HF is well controlled, principally due to major ventricular arrhythmia. In Framingham study, one third of patients with HF died suddenly (SCD). While diuretics have made a major impact on the main symptoms of HF, edema and breathless, they did no change mortality. It was only with introduction of vasodilators and ACE Inhibitors that the total mortality was altered as shown by many trials like VHeFT and CONSENSUS etc. However, sudden cardiac death (SCD) remained unreduced. This is because HF is not only a syndrome of excess fluids. Hopes were transiently raised by Angiotensin-II Blockers (AT-II blockers) when ELITE-I trial showed reduced SCD as compared to ACE-Inhibitors. These hope soon vanished by ELITE -II, which confirmed that neither ACE-Inhibitors nor AT- II blocker reduced SCD. The major impact on SCD was only consistently shown with Implantable Defibrillators (ICD) that have become a cornerstone in management of selected patients at risk of SCD.