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Lack of early etiologic investigations in young sudden cardiac death

Ardalan Sharifzadehgan1, Bamba Gaye2, Wulfran Bougouin3

  • 1European Georges Pompidou Hospital, Cardiology Department, Paris, France; Paris Cardiovascular Research Center (PARCC), Paris, France; University of Paris Cité, Paris, France.

Resuscitation
|July 5, 2022
PubMed

Insights

Early investigations for sudden cardiac arrest (SCA) are crucial for understanding and preventing deaths, especially in young individuals. Many young SCA cases remain unexplained due to insufficient early diagnostic work-up in intensive care units (ICUs).

Area of Science:

  • Cardiology
  • Public Health
  • Medical Research

Background:

  • Sudden cardiac arrest (SCA) often results in death within the intensive care unit (ICU).
  • Early etiological investigations are vital for understanding SCA and developing targeted prevention strategies.

Purpose of the Study:

  • To assess the extent of early etiological work-up in young sudden cardiac death (SCD) cases (<45 years) who died in the ICU.
  • To determine the proportion of unexplained SCD cases and associated diagnostic practices.

Main Methods:

  • A prospective, population-based registry of all SCA patients admitted alive across 48 hospitals in the Paris area.
  • Analysis of etiological investigations (coronary angiography, CT scan, echocardiography) in young SCD cases dying in the ICU.

Main Results:

  • Over 7 years, 484 young SCD cases died in the ICU, with etiology unexplained in 51.9%.
  • Unexplained cases showed significantly less frequent coronary angiography, CT scans, and echocardiography.
  • The rate of unexplained SCD decreased over time, with increased use of CT and echocardiography, but not coronary angiography.

Conclusions:

  • A significant proportion of young SCD deaths in the ICU remain unexplained due to inadequate early investigations.
  • Improving early diagnostic work-up can enhance understanding and prevention of SCA, including identifying familial conditions to prevent further deaths.
Abstract

Keywords:
Etiologic InvestigationsIntensive CareInterdisciplinarySudden Cardiac ArrestYoung

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