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Recurrent Out-of-Hospital Sudden Cardiac Arrest: Prevalence and Clinical Factors.
Elizabeth P Held1, Kyndaron Reinier1, Harpriya Chugh1
1Center for Cardiac Arrest Prevention, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA (E.P.H., K.R., H.C., A.U.-E., S.S.C.).
Circulation. Arrhythmia and Electrophysiology
|November 16, 2022
Summary
Recurrent sudden cardiac arrest (SCA) affects 10% of survivors, often despite treatment. Managing underlying conditions like heart disease and diabetes in SCA survivors is crucial to prevent repeat events.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Sudden cardiac arrest (SCA) survivors face a risk of recurrent events despite advances in care.
- Implantable cardioverter-defibrillators are available for secondary prevention, yet a subset of individuals experience multiple SCA episodes.
Purpose of the Study:
- To characterize the burden of recurrent out-of-hospital sudden cardiac arrest (SCA) among survivors.
- To evaluate the clinical factors associated with recurrent SCA in a large US community.
Main Methods:
- Prospective and retrospective identification of SCA cases within the Oregon Sudden Unexpected Death Study (2002-2020).
- Analysis of 6649 SCA cases, focusing on 924 hospital survivors and identifying those with recurrent SCA events.
Main Results:
- 10% of SCA survivors (88 individuals) experienced recurrent out-of-hospital SCA.
- Recurrent SCA occurred in 22% of cases despite secondary prevention implantable cardioverter-defibrillators.
- Higher prevalence of coronary disease, hypertension, diabetes, and chronic kidney disease was observed in recurrent SCA survivors compared to single SCA survivors.
Conclusions:
- At least 10% of sudden cardiac arrest survivors experience recurrent events.
- A significant portion of recurrent SCAs occur despite treatment for reversible causes.
- Improved management of cardiac substrate and comorbidities (coronary disease, hypertension, diabetes, kidney disease) in SCA survivors may reduce recurrence.
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