Comprehensive assessment of unexplained sudden cardiac death and idiopathic ventricular fibrillation during the index hospitalization: A systematic thorough investigation to unmask specific etiology

AbstractEarly repolarization pattern (ERP), a form of J-wave syndromes, was considered long time a benign ECG phenomenon. However, recent data confirmed that certain phenotypes of ERP are related to an increased risk of sudden cardiac death (idiopathic ventricular fibrillation). Our paper gives a short and practical update regarding the main issues related to ERP: epidemiological data, molecular and electrophysiological background, clinical significance and risk stratification. At the end, the future directions of research and clinical management related to ERP are presented.

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Survivors of sudden cardiac death: a rational approach to evaluation and therapy of patients surviving ventricular fibrillation

Cleveland Clinic Journal of Medicine ◽

10.3949/ccjm.59.2.166 ◽

1992 ◽

Vol 59 (2) ◽

pp. 166-172 ◽

Cited By ~ 5

Author(s):

A. J. Rabinowitz ◽

J. D. Maloney

Keyword(s):

Sudden Cardiac Death ◽

Ventricular Fibrillation ◽

Cardiac Death ◽

Rational Approach

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Electrically-Induced Ventricular Fibrillation Alters Cardiovascular Function and Expression of Apoptotic and Autophagic Proteins in Rat Hearts

International Journal of Molecular Sciences ◽

10.3390/ijms20071628 ◽

2019 ◽

Vol 20 (7) ◽

pp. 1628 ◽

Cited By ~ 4

Author(s):

Andras Czegledi ◽

Agnes Tosaki ◽

Alexandra Gyongyosi ◽

Rita Zilinyi ◽

Arpad Tosaki ◽

...

Keyword(s):

Sudden Cardiac Death ◽

Ventricular Fibrillation ◽

Cardiac Death ◽

Caspase 3 ◽

Recovery Period ◽

Heart Rhythm ◽

Heart Tissue ◽

Altered Expression ◽

Cardiac Functions ◽

Rat Hearts

Background: The pathological heart contractions, called arrhythmias, especially ventricular fibrillation (VF), are a prominent feature of many cardiovascular diseases leading to sudden cardiac death. The present investigation evaluates the effect of electrically stimulated VF on cardiac functions related to autophagy and apoptotic mechanisms in isolated working rat hearts. Methods: Each group of hearts was subjected to 0 (Control), 1, 3, or 10 min of spacing-induced VF, followed by 120 min of recovery period and evaluated for cardiac functions, including aortic flow (AF), coronary flow (CF), cardiac output (CO), stroke volume (SV), and heart rate (HR). Hearts were also evaluated for VF effects on infarcted zone magnitude and Western blot analysis was conducted on heart tissue for expression of the apoptotic biomarker cleaved-caspase-3 and the autophagy proteins: p62, P-mTOR/mTOR, LC3BII/LC3BI ratio, and Atg5-12 complexes. Results: Data revealed that VF induced degradation in AF, CF, CO, and SV, which prominently included-variable post-VF capacity for recovery of normal heart rhythm; increased extent of infarcted heart tissue; altered expression of cleaved-caspase-3 suggesting potential for VF-mediated amplification of apoptosis. VF influence on expression of p62, LC3BII/LC3BI, and Atg5-12 proteins was complex, possibly due to differential effects of VF-induced expression on proteins comprising the autophagic program. Conclusions: VF was observed to cause time-dependent changes in autophagy processes, which with additional analysis under ongoing investigations, likely to yield novel therapeutic targets for the prevention of VF and sudden cardiac death.

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Early repolarisation among athletes

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2019-000694 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000694

Author(s):

Femke M A P Claessen ◽

Heidi A P Peeters ◽

Bastiaan J Sorgdrager ◽

Peter L J van Veldhoven

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Sudden Cardiac Death ◽

Ventricular Fibrillation ◽

Outpatient Clinic ◽

Cardiac Death ◽

Multivariable Analysis ◽

Control Group ◽

Multivariable Logistic Regression Analysis ◽

Athlete Group

ObjectivesTraditionally, early repolarisation (ER) is considered a benign ECG variant, predominantly found in youths and athletes. However, a limited number of studies have reported an association between ER and the incidental occurrence of ventricular fibrillation or sudden cardiac death. Yet definite, direct comparisons of the incidence of ER in unselected, contemporary populations in athletes as compared with non-athletes and across different sports are lacking. This study therefore aimed to investigate whether ER is more common among athletes as compared with non-athletes, and if ER patterns differ between sport disciplines based on static and dynamic intensity.MethodsTo assess ER we retrospectively analysed ECGs of 2241 adult subjects (2090 athletes, 151 non-athletes), who had a sports medical screening between 2010 and 2014 in an outpatient clinic. The outcome was tested for confounders in a multivariable logistic regression analysis.ResultsER was found in 502 athletes (24%). We found a 50% higher prevalence of ER in the athlete group compared with the control group (OR 1.5 (SE 0.34), adjusted 95% CI 1.0 to 2.4) in multivariable analysis. A 30% higher prevalence of ER in the inferior leads only (OR 1.3 (SE 0.38), adjusted 95% CI 0.74 to 2.3), a 120% higher prevalence of ER in the lateral leads only (OR 2.2 (SE 1.0), adjusted 95% CI 0.87 to 5.4), and a 20% higher prevalence of ER in the inferior and lateral leads (OR 1.2 (SE 0.49), adjusted 95% CI 0.55 to 2.7) was found in athletes.ConclusionAthletes had a 50% higher prevalence of ER and a 30% higher prevalence of ER in the inferior leads specifically. There was no association between training duration or sports discipline and ER.

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