Abstract 15571: Analysis of Out-of-hospital Cardiac Arrest in Infants, Children, < Adolescents in Japan
Background: A prospective population-based study using the Utstein style has obtained data on patients suffering OHCA since 2005 in Japan. Additional information may help determine confounders present in each case and aid in preventing OHCA in infants, children, and adolescents.
Methods and Results: A council for prevention of cardiovascular diseases in childhood of Kyushu Medical Association began obtaining data on OHCA (<20 years of age) from local fire departments and school officials in the Kyushu area in 2013. The questionnaire sought data using the Utstein style and additional data on: presence/absence of underlying diseases; location of OHCA; and activities before/surrounding OHCA, including school activities. A total of 276 cases were obtained: aged 0 (84 cases); aged 1-5 (53 cases); aged 6-12 (42 cases); and aged 13-19 (97 cases). Among 166 cases that occurred at home, 86% (136/159; seven cases unknown whether dead/alive) were fatal. In 84 infants, 65% (55 cases) occurred during sleep. Of these, 96% (51/53; two cases with unknown prognosis) were fatal. Prevalent situations/locations were during sleep (44%) in aged 1-5, water accident (35%) in aged 6-12, and suicide (25%) and exercise-related (24%) in aged 13-18, respectively. Of 28 OHCA cases with underlying cardiovascular diseases, cardiomyopathy (eight cases: HCM 7, DCM 1), arrhythmia (seven cases: CPVT 2, LQTS 1, SSS 1, VT 1, AF 1, VT/ICD implantation 1), and congenital heart diseases (six cases: aberrant origin of coronary artery 1, VSD/Eisenmenger 1, TOF (postoperative) 2, dTGA (P/O) 1, CoA (P/O) 1) were prevalent causes.
Conclusions: New strategies to prevent sudden death during sleep should be examined and implemented for infants. Cardiomyopathy/arrhythmia/postoperative chronic heart disease are still major causes of cardiovascular-related OHCA. Diagnostic criteria with high sensitivity and specificity should be determined to screen cardiomyopathy and/or arrhythmia in younger age groups. The recommendation and support not to start competitive sports activities should be infromed not only to the parents but to the young.
Author Disclosures: M. Yoshinaga: None.
- © 2016 by American Heart Association, Inc.