Abstract 16016: Cardiac Etiologies Underlying Sudden Death in the Community
Introduction: A comprehensive assessment of cardiac etiologies underlying sudden cardiac death (SCD) in the general population has not been addressed on a large scale so far.
Hypothesis: We aimed to evaluate the pattern and distribution of cardiovascular diseases associated with SCD among patients discharged alive from intensive care units.
Methods: All cases of sudden cardiac arrest (SCA) in Paris and suburbs (6.6 million inhabitants) were prospectively included in the Paris-SDEC registry, in close collaboration with Emergency Medical Services, Medical examiners, and hospitals.
Results: Over a 4-year period, 14,822 out-of-hospital SCA occurred; 785 patients were alive at Intensive Care Unit discharge, of which 556 (3.8%) satisfied the definition for SCD (mean age 56.3 ±15.3 years, 82% male). Among SCD associated with coronary artery disease, the vast majority was related to acute coronary syndrome (295, 79%), whereas the rest had chronic ischemic heart disease (21%). No structural heart disease was identified in 56 patients (10%), including 5 Brugada, 4 early repolarization, 2 long QT and 2 Wolff-Parkinson-White syndromes, with 43 (7.7%) being diagnosed to have idiopathic ventricular fibrillation. Warning cardiovascular symptoms within the 4 weeks prior to SCD were reported in 232 patients (42%). One third of patients were known with heart disease identified prior to SCD event.
Conclusions: Our findings outline the pattern of cardiac diseases associated with SCD in the community and emphasize the high prevalence of acute coronary syndrome among patients resuscitated from SCD. A significant proportion of subjects with symptoms prior to SCD suggests room for pre-emptive action and subacute prevention.
Author Disclosures: V. Waldmann: None. W. Bougouin: None. M. Bories: None. K. Narayanan: None. D. Jost: None. B. Ludes: None. V. Algalarrondo: None. E. Gandjbakhch: None. F. Extramiana: None. N. Lellouche: None. F. Beganton: None. L. Lamhaut: None. T. Lavergne: None. X. Jouven: None. E. Marijon: None.
- © 2016 by American Heart Association, Inc.