Circadian patterns and triggers of sudden cardiac death.

Sudden cardiac death and other acute cardiovascular events have been demonstrated to occur in certain temporal patterns. The study of these patterns may yield important clues to the pathophysiology of the disease process. Most studies of the timing of onset of sudden cardiac death have revealed a prominent midmorning peak, thought to be related to a surge in catecholamines associated with arising and assuming the upright posture, that is blunted or eliminated by beta blockers. In addition, some studies have also shown a secondary peak in late afternoon or early evening of uncertain cause. The development of third-generation implantable cardioverter defibrillators with memory capabilities offers a unique opportunity to accurately define event chronology.