Abstract 14270: Decline in Incidence of Sudden Cardiac Death Caused by Congenital Heart Disease After Implementation of Nationwide Prenatal Ultrasound Screening: A Nationwide Study
Introduction: Congenital heart defects (CHD) affect 8 in every 1,000 live births. CHD is one of the leading causes of sudden cardiac death (SCD) in children and the young. However, the incidence of SCD caused by CHD (SCD-CHD) in the young general population is unknown. The aims of this study were to investigate the incidence and causes of SCD-CHD, how the implementation of nationwide prenatal ultrasound screening in 2005 has changed the epidemiology of SCD-CHD in children, and to which extent CHD was diagnosed antemortem in the SCD cases.
Methods and Results: The study population consisted of all persons aged 0-35 years in Denmark in 2000-09, which equals 24.4 million person-years. All 11,451 deaths were included. By using the in depth descriptive Danish death certificates, 1,094 cases of sudden and unexpected death were identified. Through review of autopsy reports, records from hospitals and general practitioners, discharge summaries, and data from The National Patient Registry on medical history, we identified 103 cases of SCD-CHD (9.4% of all sudden deaths). Median age at time of death was 13 years. In total, only 60 (58%) were diagnosed with CHD prior to death. The annual incidence rate of SCD-CHD was 0.42 per 100,000 person-years among persons aged 0-35 years in the 10-year period. The annual incidence rate for infants (< 1 year old) born prior to implementation of nationwide prenatal ultrasound screening was higher than the incidence rate for infants born after implementation (incidence rate ratio 3.2. 95% CI, 1.4-7.2, p=0.005) (Fig. 1). The most common causes of SCD-CHD were coarctation of the aorta (n=16, 15%) and transposition of the great arteries (n=13, 13%).
Conclusion: A total of 9.4% of all sudden deaths in the young is caused by congenital heart disease. Only 58% of SCD-CHD cases were diagnosed with CHD prior to death. We observed a significant decline in incidence of SCD caused by CHD among infants after implementation of nationwide prenatal ultrasound screening.
- Sudden cardiac death
- Congenital heart disease
- Pediatric cardiology
- Adult congenital heart disease
Author Disclosures: T. Lynge: None. A. Jeppesen: None. B. Winkel: None. L. Søndergaard: None. B. Risgaard: None. J. Tfelt-Hansen: None.
- © 2016 by American Heart Association, Inc.