scholarly journals Association of minor heart anomalies with risks of sudden cardiac death

2018 ◽  
Vol 22 (1) ◽  
pp. 16 ◽  
Author(s):  
V. A. Kuznetsov ◽  
A. M. Soldatova ◽  
A. V. Fanakov
Keyword(s):  
High Risk ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Connective Tissue ◽  
Conflict Of Interest ◽  
Cardiac Death ◽  
Prevention Measures ◽  
Arrhythmogenic Effect ◽  
Study Results ◽  
Heart Abnormalities

<p>The review focuses on the analysis of study results related to a possible arrhythmogenic effect of minor heart abnormalities and their significance in the stratification of sudden cardiac death risks. Risk stratification of sudden cardiac death is a challenging problem of modern cardiology. Ventricular arrhythmias followed by asystolia are considered to be the main mechanisms of sudden cardiac death development. The incidence of sudden cardiac death is not high in general population but in absolute values it is significantly higher than that in high risk patients. Therefore, additional identification of sudden cardiac death risks in general population and prevention measures seem to be of special interest. Some researchers think that connective-tissue dysplasia followed by the formation of minor heart abnormalities might serve as a potential substrate for arrhythmia development and describe their arrhythmogenic effect. However, the association of minor heart abnormalities with sudden cardiac death risks is not well studied. The literature gives some data on sudden cardiac death incidence in some connective-tissue pathologies, but no variants of minor heart abnormalities leading to sudden cardiac death are described both in domestic and foreign literature. Also, the patients with these pathologies are not included in the sudden cardiac death high risk group.</p><p>Received 14 November 2017. Revised 4 December 2017. Accepted 19 December 2017.</p><p><strong>Funding:</strong> The study was done with support of Tyumen Cardiology Research Center.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: V.A. Kuznetsov<br />Data collection and analysis: A.M. Soldatova, A.V. Fanakov <br />Drafting the article: A.M. Soldatova<br />Critical revision of the article: V.A. Kuznetsov, A.M. Soldatova <br />Literature review: A.M. Soldatova, A.V. Fanakov<br />Final approval of the version to be published: V.A. Kuznetsov, A.M. Soldatova, A.V. Fanakov</p>

scholarly journals Screening general population for family history of sudden cardiac death unmasks high risk individuals as potential victims (pilot study)

2018 ◽  
Vol 6 (1) ◽  
pp. 9-16
Author(s):  
Lamia Hamid ◽  
Alia Abdelfattah ◽  
Khaled Hussien ◽  
Khaled Farouk ◽  
Mohamed Amin ◽  
...  
Keyword(s):  
Pilot Study ◽  
Family History ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Cardiac Death ◽  
History Of

Abstract 13286: Non-Specific Intraventricular Conduction Delay and Risk of Sudden Death

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Audrey Uy-Evanado ◽  
Carmen Teodorescu ◽  
Kyndaron Reinier ◽  
Kumar Narayanan ◽  
Harpriya Chugh ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
General Population ◽  
Left Bundle Branch Block ◽  
Cardiac Death ◽  
Conduction Delay ◽  
Bundle Branch Block ◽  
Intraventricular Conduction ◽  
Qrs Morphology ◽  
Qrs Duration ◽  
Intraventricular Conduction Delay

Introduction: We and others have reported an independent association between prolonged QRS duration and risk of sudden cardiac death (SCD) in the general population. Left and right bundle branch block have been studied previously, but there is little information regarding non-specific intraventricular conduction delay and risk of SCD. Hypothesis: Completed conduction defects, including non-specific IVCD, are associated with increased SCD risk. Methods: Sudden cardiac death cases and controls from an ongoing large population based study in the Northwestern US (2002 to 2010) were included if age ≥ 35 years with a non-paced 12-lead ECG (recorded prior and unrelated to SCD in cases). QRS morphology was subcategorized as normal, intermediate [left anterior fascicular block (LAFB), left posterior fascicular block (LPFB), and incomplete right or left bundle branch block (IRBBB/ILBBB)] or completed conduction defects [left bundle branch block (LBBB), right bundle branch block (RBBB), or nonspecific intraventricular conduction delay (IVCD)]. Comparisons were conducted using chi-square tests for categorical variables and independent samples t-tests for continuous variables. Logistic regression was used to evaluate the association of QRS morphology with SCD. Results: We evaluated 761 SCD cases (64% male) and 539 controls (65% male). Cases were significantly older (69.7 vs 66.3 years, p<0.0001) with greater QRS duration (102 vs. 98 ms, p=0.001). For conduction categories, intermediate or completed conduction defects were significantly more common in cases whereas normal QRS morphology was more common among controls (p=0.01). And for specific morphology overall, QRS morphology patterns differed between cases and controls (p=0.03); abnormal QRS morphologies were more frequent in cases than controls except for LAFB. After adjustment for age and gender, however, only a finding of LBBB or non-specific IVCD remained a significant predictor of SCD [OR 1.34 (95% CI 1.03-1.75)]. Conclusions: LBBB and non-specific IVCD, but not RBBB, are significant predictors of SCD in the general population. These findings contribute to the utility of the 12-lead EKG for SCD risk stratification.

scholarly journals Sudden cardiac death rates in an Australian population: a data linkage study

2015 ◽  
Vol 39 (5) ◽  
pp. 561 ◽  
Author(s):  
Jia-Li Feng ◽  
Siobhan Hickling ◽  
Lee Nedkoff ◽  
Matthew Knuiman ◽  
Christopher Semsarian ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Sudden Cardiac Death ◽  
Cause Of Death ◽  
Cardiac Death ◽  
Linkage Study ◽  
Mortality Data ◽  
Prevention Measures ◽  
Hospital Morbidity

Objective The aim of the present study was to develop criteria to identify sudden cardiac death (SCD) and estimate population rates of SCD using administrative mortality and hospital morbidity records in Western Australia. Methods Four criteria were developed using place, death within 24 h, principal and secondary diagnoses, underlying and associated cause of death, and/or occurrence of a post mortem to identify SCD. Average crude, age-standardised and age-specific rates of SCD were estimated using population person-linked administrative data. Results In all, 9567 probable SCDs were identified between 1997 and 2010, with one-third aged ≥35 years having no prior admission for cardiovascular disease. SCD was more frequent in men (62.1%). The estimated average annual crude SCD rate for the period was 34.6 per 100 000 person-years with an average annual age-standardised rate of 37.8 per 100 000 person-years. Age-specific standardised rates were 1.1 per 100 000 person-years and 70.7 per 100 000 person-years in people aged 1–34 and ≥35 years, respectively. Ischaemic heart disease (IHD) was recorded as the underlying cause of death in approximately 80% of patients aged ≥35 years, followed by valvular heart disease and heart failure. IHD was the most common cause of death in those aged 1–34 years, followed by unspecified cardiomyopathy and dysrhythmias. Conclusions Administrative morbidity and mortality data can be used to estimate rates of SCD and therefore provide a suitable methodology for monitoring SCD over time. The findings highlight the magnitude of SCD and its potential for public health prevention. What is known about the topic? There is considerable variability in rates of SCD worldwide. Different data sources and varied methods of case ascertainment likely contribute to this variation. What does this paper add? The rate of SCD in Australia is low compared with international estimates from USA, Ireland, Netherlands and China. Two in every three cases of SCD aged ≥35 years had a hospitalisation history of cardiovascular disease, highlighting the opportunity for prevention. What are the implications for practitioners? High-quality person-linked administrative hospital morbidity and registered mortality data can be used to estimate rates of SCD in the population. Understanding the magnitude and distribution of SCD is imperative for developing effective public health policy and prevention measures.

Abstract 15714: Prediction of Sudden Cardiac Death With Automated High-Throughput Analysis of T-Wave Heterogeneity in Standard 12-Lead Electrocardiogram

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tuomas Kenttä ◽  
Bruce D Nearing ◽  
Kimmo Porthan ◽  
Jani T Tikkanen ◽  
Matti Viitasalo ◽  
...  
Keyword(s):  
At Risk ◽  
Relative Risk ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Adjusted Relative Risk ◽  
T Wave ◽  
Increased Risk ◽  
Patients At Risk

Introduction: Noninvasive identification of patients at risk for sudden cardiac death (SCD) remains a major clinical challenge. Abnormal ventricular repolarization is associated with increased risk of lethal ventricular arrhythmias and SCD. Hypothesis: We investigated the hypothesis that spatial repolarization heterogeneity can identify patients at risk for SCD in general population. Methods: Spatial R-, J- and T-wave heterogeneities (RWH, JWH and TWH, respectively) were automatically analyzed with second central moment technique from standard digital 12-lead ECGs in 5618 adults (46% men; age 50.9±12.5 yrs.) who took part in Health 2000 Study, an epidemiological survey representative of the entire Finnish adult population. During average follow-up of 7.7±1.4 years, a total of 72 SCDs occurred. Thresholds of RWH, JWH and TWH were based on optimal cutoff points from ROC curves. Results: Increased RWH, JWH and TWH (Fig.1) in left precordial leads (V4-V6) were univariately associated with SCD (P<0.001, each). When adjusted with clinical risk markers (age, gender, BMI, systolic blood pressure, cholesterol, heart rate, left ventricular hypertrophy, QRS duration, arterial hypertension, diabetes, coronary heart disease and previous myocardial infarction) JWH and TWH remained as independent predictors of SCD. Increased TWH (≥102μV) was associated with a 1.9-fold adjusted relative risk (95% confidence interval [CI]: 1.2 - 3.1; P=0.011) and increased JWH (≥123μV) with a 2.0-fold adjusted relative risk for SCD (95% CI: 1.2 - 3.3; P=0.004). When both TWH and JWH were above threshold, the adjusted relative risk for SCD was 3.2-fold (95% CI: 1.7 - 6.2; P<0.001). When all heterogeneity measures (RWH, JWH and TWH) were above threshold, the risk for SCD was 3.7-fold (95% CI: 1.6 - 8.6; P=0.003). Conclusions: Automated measurement of spatial J- and T-wave heterogeneity enables analysis of high patient volumes and is able to stratify SCD risk in general population.

Secondary prevention of sudden cardiac death in ischaemic cardiomyopathy

ESC CardioMed ◽  
2018 ◽  
pp. 2337-2341
Author(s):  
Jens Cosedis Nielsen ◽  
Jens Kristensen
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Heart Disease ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
Secondary Prevention ◽  
Cardiac Death ◽  
Cardioverter Defibrillator ◽  
Ischaemic Cardiomyopathy ◽  
Life Threatening

The most common reason for sudden cardiac death is ischaemic heart disease. Patients who survive cardiac arrest are at particularly high risk of recurrent ventricular arrhythmia and sudden cardiac death, and are candidates for secondary prevention defined as ‘therapies to reduce the risk of sudden cardiac death in patients who have already experienced an aborted cardiac arrest or life-threatening arrhythmias’. The mainstay therapy for secondary prevention of sudden cardiac death is implantation of an implantable cardioverter defibrillator. Furthermore, revascularization and optimal medical therapy for heart failure and concurrent cardiovascular diseases should be ensured.

Tachycardias

2014 ◽  
pp. 243-260 ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Implantable Cardioverter Defibrillator ◽  
Cardiac Death ◽  
Cardioverter Defibrillator ◽  
Priority Areas ◽  
Diagnosis And Management ◽  
Broad Complex

This chapter looks at the diagnosis and management of tachycardias, including both narrow complex tachycardias and broad complex tachycardias. Atrial fibrillation (AF) is the most common sustained arrhythmia, affecting 1–2% of the general population (5–15% of those over 80 years). There have been a number of developments in arrhythmia care over the last few years in particular in relation to AF and there are now more specialist arrhythmia nurses and nurse-led arrhythmia services than before. AF, arrhythmias, and sudden cardiac death are priority areas of NHS improvement. Recent guidelines for the management of tachycardias are discussed including pharmacological measure, cardioversion, and implantable cardioverter-defibrillator (ICD) insertion.

Incidence of adequate ICD interventions in patients with hypertrophic cardiomyopathy supposed to be at high risk for sudden cardiac death

2010 ◽  
Vol 65 (5) ◽  
pp. 521-525 ◽  
Author(s):  
Christian Prinz ◽  
Jürgen Vogt ◽  
Thomas Bitter ◽  
Bogdan G. Muntean ◽  
Detlef Hering ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
Cardiac Death

scholarly journals Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Xiaoyao Li ◽  
Shuang Zhao ◽  
Keping Chen ◽  
Wei Hua ◽  
Yangang Su ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
High Risk ◽  
Sudden Cardiac Death ◽  
Dose Response ◽  
Cardiac Death ◽  
Cox Regression ◽  
Cardiac Resynchronization ◽  
All Cause Mortality

Abstract Background Cardiovascular implantable electronic devices (CIEDs) with physical activity (PA) recording function can continuously and automatically collect patients’ long-term PA data. The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated. Methods In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (< 8.04%, n = 274), tertile 2 (8.04–13.24%, n = 274), and tertile 3 (> 13.24%, n = 274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality. Results During a mean follow-up of 59.7 ± 22.4 months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1–3, P < 0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1–3, P < 0.001) events decreased according to PA tertiles. Compared with patients younger than 60 years old, older patients had a lower average PA level (9.6% vs 12.8%, P < 0.001) but higher rates of cardiac death (13.2% vs 8.1%, P = 0.024) and all-cause mortality (28.4% vs 16.7%, P < 0.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25–0.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15–0.51, tertile 3 vs tertile 1, Ptrend < 0.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177 min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172 min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower. Conclusions PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.

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