Abstract 16782: Contribution of the Primary Arrhythmia Syndromes to Sudden Cardiac Arrest in the General Population: Prospective, 8-Year Study in a Large US Community
Introduction: While some estimates are available for the burden of the primary arrhythmia disorders such as long QT syndrome and hypertrophic cardiomyopathy, systematic, prospective evaluations in populations of adequate size are lacking.
Methods: We evaluated the frequency of SCA due to primary arrhythmia syndromes in an ongoing community-based study of one million residents in the northwestern US (2002-09). Analysis was restricted to cases of SCA (non-survivors plus survivors), age>10 years. We performed a detailed analysis of the available electrocardiograms, pre-mortem medical records as well as post-mortem evaluation.
Results: A total of 1537 SCD cases enrolled during the study period had adequate information available for analysis. Among patients ≥ 35 years, 44.6% had medically documented significant CAD. While postmortem examination was performed in only 17% of total cases, autopsy findings among that subset and from previous postmortem studies of SCD patients indicate that a large majority (>80%) of the remainder of subjects is also likely to have CAD. However, a primary arrhythmia syndrome was diagnosed or apparent on ECG in 3% of all cases, with frequencies as follows: Hypertrophic cardiomyopathy (n=20; 1.3%), idiopathic VF (n=21; 1.4%), long QT syndrome (n=2; <1%), ECG evidence of Brugada pattern (n=2; <1%) and ARVD (n=1; <1%). No cases were identified as short QT syndrome or catacholaminergic polymorphic ventricular tachycardia.
Conclusions: Primary arrhythmia syndromes contributed to at least 3% of all SCD cases in this US community. Given the study design, this likely represents the lower limit of prevalence.
- © 2011 by American Heart Association, Inc.