Abstract 16072: Lack of Comprehensive Cardiac Investigations in Cases of Apparently Idiopathic Ventricular Fibrillation in the Community
Introduction: When no cause is found in case of sudden cardiac death (SCD), the diagnosis of idiopathic ventricular fibrillation (IVF) is considered. The extent to which such cases are fully investigated has been poorly investigated so far.
Hypothesis: We evaluated the completeness of investigation in SCD survivors cases labeled IVF.
Methods: Between May 2011 and 2015, in Paris and its suburbs, a total of 556 patients survived from SCD (Sudden Death Expertise Center registry). Among those, 43 (7.7%) were eventually diagnosed with IVF at discharge. Data from their medical records were analyzed to evaluate in which extent such cases were completely investigated, during the index hospital stay as well as during the following year.
Results: Electrocardiogram and transthoracic echocardiography were performed in all patients, coronary angiogram in 42 patients (97.7%), and cardiac magnetic resonance imaging in 36 cases (83.7%). Other cardiac investigations remained inconstantly performed in particular pharmacological provocative testing with procainamide, ergonovine or cathecolamine, electrophysiology study and exercise testing (Table 1). Genetic investigations were initiated in 7 (16.3%) patients and complete familial screening in 3 (7%).
Conclusions: Our findings suggest that, in a real life setting, there is a lack of comprehensive cardiac investigation in cases of unexplained SCD. The diagnosis of IVF is probably overused and a standardized and systematic approach, including the study of first relatives, needs to be implemented.
Author Disclosures: V. Waldmann: None. W. Bougouin: None. M. Bories: None. D. Jost: None. B. Ludes: None. V. Algalarrondo: None. E. Gandjbakhch: None. N. Lellouche: None. F. Beganton: None. L. Lamhaut: None. T. Lavergne: None. F. Extramiana: None. X. Jouven: None. E. Marijon: None.
- © 2016 by American Heart Association, Inc.