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Sudden cardiac death post arrest care and prevention

2026-04-04T14:32:07Z

Overview

← Older revision		Revision as of 14:32, 4 April 2026
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	*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.		*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.
	*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].		*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].
	*The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].
	*In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].
	*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.
	*In absence of noncardiac or reversible causes, an implantable cardioverter-defibrillator (ICD) is recommended because of the high risk of recurrent lethal ventricular arrhythmias. Adjunctive therapy (eg, amiodarone, catheter ablation) and lifestyle modifications for certain genetic arrhythmia syndromes may reduce ventricular arrhythmia recurrence after ICD placement.		*In absence of noncardiac or reversible causes, an implantable cardioverter-defibrillator (ICD) is recommended because of the high risk of recurrent lethal ventricular arrhythmias. Adjunctive therapy (eg, amiodarone, catheter ablation) and lifestyle modifications for certain genetic arrhythmia syndromes may reduce ventricular arrhythmia recurrence after ICD placement.

	== Prevention ==		== Prevention ==

			=== Primary prevention: ===
	*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[ICD]] implantation based on the guideline.<ref name="Al-KhatibStevenson2018">{{cite journal\|last1=Al-Khatib\|first1=Sana M.\|last2=Stevenson\|first2=William G.\|last3=Ackerman\|first3=Michael J.\|last4=Bryant\|first4=William J.\|last5=Callans\|first5=David J.\|last6=Curtis\|first6=Anne B.\|last7=Deal\|first7=Barbara J.\|last8=Dickfeld\|first8=Timm\|last9=Field\|first9=Michael E.\|last10=Fonarow\|first10=Gregg C.\|last11=Gillis\|first11=Anne M.\|last12=Granger\|first12=Christopher B.\|last13=Hammill\|first13=Stephen C.\|last14=Hlatky\|first14=Mark A.\|last15=Joglar\|first15=José A.\|last16=Kay\|first16=G. Neal\|last17=Matlock\|first17=Daniel D.\|last18=Myerburg\|first18=Robert J.\|last19=Page\|first19=Richard L.\|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death\|journal=Circulation\|volume=138\|issue=13\|year=2018\|issn=0009-7322\|doi=10.1161/CIR.0000000000000549}}</ref>		*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[ICD]] implantation based on the guideline.<ref name="Al-KhatibStevenson2018">{{cite journal\|last1=Al-Khatib\|first1=Sana M.\|last2=Stevenson\|first2=William G.\|last3=Ackerman\|first3=Michael J.\|last4=Bryant\|first4=William J.\|last5=Callans\|first5=David J.\|last6=Curtis\|first6=Anne B.\|last7=Deal\|first7=Barbara J.\|last8=Dickfeld\|first8=Timm\|last9=Field\|first9=Michael E.\|last10=Fonarow\|first10=Gregg C.\|last11=Gillis\|first11=Anne M.\|last12=Granger\|first12=Christopher B.\|last13=Hammill\|first13=Stephen C.\|last14=Hlatky\|first14=Mark A.\|last15=Joglar\|first15=José A.\|last16=Kay\|first16=G. Neal\|last17=Matlock\|first17=Daniel D.\|last18=Myerburg\|first18=Robert J.\|last19=Page\|first19=Richard L.\|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death\|journal=Circulation\|volume=138\|issue=13\|year=2018\|issn=0009-7322\|doi=10.1161/CIR.0000000000000549}}</ref>
	*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]], [[ICD]] implantation.		*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]], [[ICD]] implantation.

			=== Secondary prevention: ===
			*'''Myocardial Infarcation:''' The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].
			*VF due to acute MI with coronary plaque rupture and/or thrombus (typically <48 hours), risk of a recurrent event is reduced after early revascularization such as percutaneous coronary intervention. Implantable cardioverter-defibrillator (ICD) is not indicated for secondary prevention.<ref name="pmid36017572" />,<ref>Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997;337(22):1576-1583. doi:10.1056/ NEJM199711273372202</ref>
			*'''Heart failure:''' In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].
			*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.
			*'''Coronary anomalies:''' Surgical intervention is recommended to survivors with coronary anomalies such as congenital left main artery atresia and anomalous aortic origin of a coronary artery to prevent recurrence.<ref name="pmid36017572" /><ref name="Al-KhatibStevenson2018" /><ref>Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(14):e698-e800.</ref>
			*'''Toxins:''' .If the cardiac arrest involved stimulants or supplements, avoidance of these substances can prevent recurrence. For patients with an event caused by an opioid overdose, counseling, education, and medications to treat opioid use disorder (eg, buprenorphine, methadone, and naltrexone) are recommended to decrease the risk of recurrence.<ref>Dezfulian C, Orkin AM, Maron BA, et al; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research;and Council on Clinical Cardiology. Opioid-associated out-of-hospital cardiac arrest: distinctive clinical features and implications for health care and public responses: a scientific statement from the American Heart Association. Circulation. 2021;143 (16):e836-e870. doi:10.1161/CIR. 0000000000000958</ref>
			*'''Epilepsy:''' Survivors with a previously undiagnosed seizure disorder should be treated and closely followed up given a more than 20-fold higher risk of sudden unexplained death in persons with epilepsy compared with the general population.<ref>Ficker DM, So EL, Shen WK, et al. Population-based study of the incidence of sudden unexplained death in epilepsy. Neurology. 1998;51 (5):1270-1274. doi:10.1212/WNL.51.5.1270</ref>

	==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==		==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==

Sudden cardiac death other diagnostic studies

2026-04-04T14:03:47Z

Electrophysiology Study

← Older revision		Revision as of 14:03, 4 April 2026
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	===Exercise Testing===		===Exercise Testing===
	* This test is useful in the [[diagnosis]] of [[exercise-induced idiopathic monomorphic ventricular tachycardia]] ([[MVT]]), [[paroxysmal ventricular tachycardia]] ([[PVT]]), and bidirectional [[ventricular tachycardia]] <ref name="pmid30763784">{{cite journal\| author=Giudicessi JR, Ackerman MJ\| title=Exercise testing oversights underlie missed and delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia in young sudden cardiac arrest survivors. \| journal=Heart Rhythm \| year= 2019 \| volume= 16 \| issue= 8 \| pages= 1232-1239 \| pmid=30763784 \| doi=10.1016/j.hrthm.2019.02.012 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30763784 }} </ref> <ref name="pmid33888264">{{cite journal\| author=Roston TM, Kallas D, Davies B, Franciosi S, De Souza AM, Laksman ZW \| display-authors=etal\| title=Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia. \| journal=JACC Clin Electrophysiol \| year= 2021 \| volume= 7 \| issue= 4 \| pages= 437-441 \| pmid=33888264 \| doi=10.1016/j.jacep.2021.02.013 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33888264 }} </ref>.		* This test is useful in the [[diagnosis]] of [[exercise-induced idiopathic monomorphic ventricular tachycardia]] ([[MVT]]), catecholaminergic polymorphic VT(CPVT), [[paroxysmal ventricular tachycardia]] ([[PVT]]), and bidirectional [[ventricular tachycardia]] or LQTS if the QT interval does not shorten with exercise or remains prolonged during the recovery phase<ref name="pmid30763784">{{cite journal\| author=Giudicessi JR, Ackerman MJ\| title=Exercise testing oversights underlie missed and delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia in young sudden cardiac arrest survivors. \| journal=Heart Rhythm \| year= 2019 \| volume= 16 \| issue= 8 \| pages= 1232-1239 \| pmid=30763784 \| doi=10.1016/j.hrthm.2019.02.012 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30763784 }} </ref> <ref name="pmid33888264">{{cite journal\| author=Roston TM, Kallas D, Davies B, Franciosi S, De Souza AM, Laksman ZW \| display-authors=etal\| title=Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia. \| journal=JACC Clin Electrophysiol \| year= 2021 \| volume= 7 \| issue= 4 \| pages= 437-441 \| pmid=33888264 \| doi=10.1016/j.jacep.2021.02.013 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33888264 }} </ref><ref name=":0">Zeppenfeld K,Tfelt-Hansen J, de Riva M, et al; ESC Scientific Document Group.2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. EurHeartJ. 2022;43(40): 3997-4126. doi:10.1093/eurheartj/ehac262</ref><ref>Sy RW, van der Werf C, Chattha IS, et al. Derivation and validation of a simple exercise-based algorithm for prediction of genetic testing in relatives of LQTS probands. Circulation. 2011;124 (20):2187-2194. doi:10.1161/CIRCULATIONAHA.111. 028258</ref>.

	===Provocative Diagnostic Tests===		===Provocative Diagnostic Tests===
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	===Electrophysiology Study===		===Electrophysiology Study===
	*This study includes measurement of programmed electrical stimulation (PES), baseline intervals ([[His-ventricuar interval]] and [[atrial-His interval]]) and [[electroanatomical mapping]] for [[diagnosis]] and [[therapy]] <ref name="pmid1907984">{{cite journal\| author=Bourke JP, Richards DA, Ross DL, Wallace EM, McGuire MA, Uther JB\| title=Routine programmed electrical stimulation in survivors of acute myocardial infarction for prediction of spontaneous ventricular tachyarrhythmias during follow-up: results, optimal stimulation protocol and cost-effective screening. \| journal=J Am Coll Cardiol \| year= 1991 \| volume= 18 \| issue= 3 \| pages= 780-8 \| pmid=1907984 \| doi=10.1016/0735-1097(91)90802-g \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1907984 }} </ref> <ref name="pmid25150471">{{cite journal\| author=Gatzoulis KA, Tsiachris D, Arsenos P, Archontakis S, Dilaveris P, Vouliotis A \| display-authors=etal\| title=Prognostic value of programmed ventricular stimulation for sudden death in selected high risk patients with structural heart disease and preserved systolic function. \| journal=Int J Cardiol \| year= 2014 \| volume= 176 \| issue= 3 \| pages= 1449-51 \| pmid=25150471 \| doi=10.1016/j.ijcard.2014.08.068 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25150471 }} </ref> <ref name="pmid23588627">{{cite journal\| author=Gatzoulis KA, Vouliotis AI, Tsiachris D, Salourou M, Archontakis S, Dilaveris P \| display-authors=etal\| title=Primary prevention of sudden cardiac death in a nonischemic dilated cardiomyopathy population: reappraisal of the role of programmed ventricular stimulation. \| journal=Circ Arrhythm Electrophysiol \| year= 2013 \| volume= 6 \| issue= 3 \| pages= 504-12 \| pmid=23588627 \| doi=10.1161/CIRCEP.113.000216 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23588627 }} </ref> <ref name="pmid11816631">{{cite journal\| author=Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY \| display-authors=etal\| title=Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. \| journal=Pacing Clin Electrophysiol \| year= 2001 \| volume= 24 \| issue= 11 \| pages= 1623-30 \| pmid=11816631 \| doi=10.1046/j.1460-9592.2001.01623.x \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11816631 }} </ref> <ref name="pmid15358027">{{cite journal\| author=Brembilla-Perrot B, Suty-Selton C, Beurrier D, Houriez P, Nippert M, de la Chaise AT \| display-authors=etal\| title=Differences in mechanisms and outcomes of syncope in patients with coronary disease or idiopathic left ventricular dysfunction as assessed by electrophysiologic testing. \| journal=J Am Coll Cardiol \| year= 2004 \| volume= 44 \| issue= 3 \| pages= 594-601 \| pmid=15358027 \| doi=10.1016/j.jacc.2004.03.075 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15358027 }} </ref> <ref name="pmid11401129">{{cite journal\| author=Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A \| display-authors=etal\| title=Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. \| journal=J Am Coll Cardiol \| year= 2001 \| volume= 37 \| issue= 7 \| pages= 1901-7 \| pmid=11401129 \| doi=10.1016/s0735-1097(01)01246-3 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11401129 }} </ref>.		*This study includes measurement of programmed electrical stimulation (PES), baseline intervals ([[His-ventricuar interval]] and [[atrial-His interval]]) and [[electroanatomical mapping]] for [[diagnosis]] and [[therapy]] <ref name="pmid1907984">{{cite journal\| author=Bourke JP, Richards DA, Ross DL, Wallace EM, McGuire MA, Uther JB\| title=Routine programmed electrical stimulation in survivors of acute myocardial infarction for prediction of spontaneous ventricular tachyarrhythmias during follow-up: results, optimal stimulation protocol and cost-effective screening. \| journal=J Am Coll Cardiol \| year= 1991 \| volume= 18 \| issue= 3 \| pages= 780-8 \| pmid=1907984 \| doi=10.1016/0735-1097(91)90802-g \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1907984 }} </ref> <ref name="pmid25150471">{{cite journal\| author=Gatzoulis KA, Tsiachris D, Arsenos P, Archontakis S, Dilaveris P, Vouliotis A \| display-authors=etal\| title=Prognostic value of programmed ventricular stimulation for sudden death in selected high risk patients with structural heart disease and preserved systolic function. \| journal=Int J Cardiol \| year= 2014 \| volume= 176 \| issue= 3 \| pages= 1449-51 \| pmid=25150471 \| doi=10.1016/j.ijcard.2014.08.068 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25150471 }} </ref> <ref name="pmid23588627">{{cite journal\| author=Gatzoulis KA, Vouliotis AI, Tsiachris D, Salourou M, Archontakis S, Dilaveris P \| display-authors=etal\| title=Primary prevention of sudden cardiac death in a nonischemic dilated cardiomyopathy population: reappraisal of the role of programmed ventricular stimulation. \| journal=Circ Arrhythm Electrophysiol \| year= 2013 \| volume= 6 \| issue= 3 \| pages= 504-12 \| pmid=23588627 \| doi=10.1161/CIRCEP.113.000216 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23588627 }} </ref> <ref name="pmid11816631">{{cite journal\| author=Brilakis ES, Shen WK, Hammill SC, Hodge DO, Rea RF, Lexvold NY \| display-authors=etal\| title=Role of programmed ventricular stimulation and implantable cardioverter defibrillators in patients with idiopathic dilated cardiomyopathy and syncope. \| journal=Pacing Clin Electrophysiol \| year= 2001 \| volume= 24 \| issue= 11 \| pages= 1623-30 \| pmid=11816631 \| doi=10.1046/j.1460-9592.2001.01623.x \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11816631 }} </ref> <ref name="pmid15358027">{{cite journal\| author=Brembilla-Perrot B, Suty-Selton C, Beurrier D, Houriez P, Nippert M, de la Chaise AT \| display-authors=etal\| title=Differences in mechanisms and outcomes of syncope in patients with coronary disease or idiopathic left ventricular dysfunction as assessed by electrophysiologic testing. \| journal=J Am Coll Cardiol \| year= 2004 \| volume= 44 \| issue= 3 \| pages= 594-601 \| pmid=15358027 \| doi=10.1016/j.jacc.2004.03.075 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15358027 }} </ref> <ref name="pmid11401129">{{cite journal\| author=Schmitt C, Barthel P, Ndrepepa G, Schreieck J, Plewan A, Schömig A \| display-authors=etal\| title=Value of programmed ventricular stimulation for prophylactic internal cardioverter-defibrillator implantation in postinfarction patients preselected by noninvasive risk stratifiers. \| journal=J Am Coll Cardiol \| year= 2001 \| volume= 37 \| issue= 7 \| pages= 1901-7 \| pmid=11401129 \| doi=10.1016/s0735-1097(01)01246-3 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11401129 }} </ref>.
			*In case of normally structured heart and ECG inconclusive of arrythmic syndrome, it is required to further evaluate the condition with electrophysiological study (EPS),sodium channel blocker challenge, or stress ECG testing may be performed. Because delta waves in Wolff-Parkinson-White syndrome and Brugada pattern may not be apparent initially on ECGs after resuscitation, an EPS can identify and treat accessory path ways responsible for cardiac arrest.<ref>Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Heart Rhythm.2018;15(10):e190-e252. doi:10.1016/j.hrthm. 2017.10.035</ref> A sodium channel blocker challenge during EPS involves administration of drugs such as flecainide, ajmaline, and pilsicainide to unmask a type 1 Brugada ECG pattern.<ref name=":0" />

	===Genetic testing===		===Genetic testing===

Sudden cardiac death diagnostic study of choice

2026-04-04T13:50:54Z

References

← Older revision		Revision as of 13:50, 4 April 2026
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	==Overview==		==Overview==
			Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>

	In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:		In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:

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	==Diagnosis Study Of Choice==		==Diagnosis Study Of Choice==
			*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
			*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />
	*According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.		*According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.
	* [[Autopsy]] investigates whether:		* [[Autopsy]] investigates whether:
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	** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations		** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations
	** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>		** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>
	*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>		*
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

	==References==		==References==

Sudden cardiac death echocardiography and ultrasound

2026-04-04T13:46:53Z

Echocardiography

← Older revision		Revision as of 13:46, 4 April 2026
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	* [[Tamponade]]		* [[Tamponade]]
	* [[ Aorta dissection]] <ref name="ParkerSalerno2018">{{cite journal\|last1=Parker\|first1=Brian K.\|last2=Salerno\|first2=Alexis\|last3=Euerle\|first3=Brian D.\|title=The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review\|journal=Journal of Ultrasound in Medicine\|volume=38\|issue=5\|year=2018\|pages=1141–1151\|issn=0278-4297\|doi=10.1002/jum.14794}}</ref>		* [[ Aorta dissection]] <ref name="ParkerSalerno2018">{{cite journal\|last1=Parker\|first1=Brian K.\|last2=Salerno\|first2=Alexis\|last3=Euerle\|first3=Brian D.\|title=The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review\|journal=Journal of Ultrasound in Medicine\|volume=38\|issue=5\|year=2018\|pages=1141–1151\|issn=0278-4297\|doi=10.1002/jum.14794}}</ref>
			* Mitral valve prolapse<ref>Han HC, Ha FJ, Teh AW, et al.Mitral valve prolapse and sudden cardiac death:a systematic review. JAmHeartAssoc.2018;7(23):e010584.doi: 10.1161/JAHA.118.010584</ref>

Sudden cardiac death diagnostic study of choice

2026-04-04T13:43:27Z

Diagnosis Study Of Choice

← Older revision		Revision as of 13:43, 4 April 2026
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	*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>		*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />		*If intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

	==References==		==References==

Sudden cardiac death electrocardiogram

2026-04-04T13:38:49Z

← Older revision		Revision as of 13:38, 4 April 2026
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}} {{Nehal}}

	==Overview==		==Overview==

Sudden cardiac death echocardiography and ultrasound

2026-04-04T12:32:24Z

← Older revision		Revision as of 12:32, 4 April 2026
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}

	==Overview==		==Overview==

Sudden cardiac death diagnostic study of choice

2026-04-04T12:16:33Z

Overview

← Older revision		Revision as of 12:16, 4 April 2026
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	** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations		** The cause of [[SCD]] is of [[hereditary]] in origin requiring the need for [[screening]] and [[counseling]] for the next generations
	** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>		** Third person involvement was present <ref name="pmiddoi: 10.1007/s00428-017-2221-0.">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-017-2221-0. \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref> <ref name="pmiddoi: 10.1007/s00428-007-0505-5">{{cite journal\| author=Schmoldt A, Benthe HF, Haberland G\| title=Digitoxin metabolism by rat liver microsomes. \| journal=Biochem Pharmacol \| year= 1975 \| volume= 24 \| issue= 17 \| pages= 1639-41 \| pmid=doi: 10.1007/s00428-007-0505-5 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10 }} </ref>
			*Clinicians evaluating persons hospitalized after resuscitation from out-of-hospital cardiac arrest should review documented cardiac rhythm from EMS records and the circumstances of arrest, including witness accounts. They should obtain a family history of heart disease for at least 3 generations, syncope, sudden cardiac arrest, or sudden cardiac death and should evaluate for use of QT-prolonging medications, substance use (eg, cocaine, methamphetamine, or ketamine), and supplements (eg, kratom, tianeptine).<ref>Shah SA, Szeto AH, Farewell R, et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>,<ref>Post S, Spiller HA, Chounthirath T, Smith GA. Kratom exposures reported to United States poison control centers: 2011-2017. Clin Toxicol (Phila). 2019;57(10):847-854. doi:10.1080/15563650.2019. 1569236</ref>,<ref>Counts CJ, Spadaro AV, Cerbini TA, et al.Notes from the Field: Cluster of severe illness from Neptune’s fix tianeptine linked to synthetic cannabinoids—New Jersey, June-November2023. MMWR Morb Mortal Wkly Rep.2024;73(4):89-90. doi:10.15585/mmwr.mm7304a5</ref>
	*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		*Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. JAMA. 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />		*if intial evaluation failed to reveal the arrest cause, we should check for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death using transthoracic echocardiography.<ref name=":0" />

Sudden cardiac death electrocardiogram

2026-04-04T12:14:59Z

Brugada syndrome:

← Older revision		Revision as of 12:14, 4 April 2026
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	===Electrocardiogram===		===Electrocardiogram===
	An [[electrocardiogram]] ([[ECG]]) may be helpful in the diagnosis of [[Sudden cardiac death]]. Findings on [[ECG]] associated with [[ sudden cardiac arrest]] ([[SCA]]) may include:<ref name="JayaramanReinier2018">{{cite journal\|last1=Jayaraman\|first1=Reshmy\|last2=Reinier\|first2=Kyndaron\|last3=Nair\|first3=Sandeep\|last4=Aro\|first4=Aapo L.\|last5=Uy-Evanado\|first5=Audrey\|last6=Rusinaru\|first6=Carmen\|last7=Stecker\|first7=Eric C.\|last8=Gunson\|first8=Karen\|last9=Jui\|first9=Jonathan\|last10=Chugh\|first10=Sumeet S.\|title=Risk Factors of Sudden Cardiac Death in the Young\|journal=Circulation\|volume=137\|issue=15\|year=2018\|pages=1561–1570\|issn=0009-7322\|doi=10.1161/CIRCULATIONAHA.117.031262}}</ref>		An [[electrocardiogram]] ([[ECG]]) may be helpful in the diagnosis of [[Sudden cardiac death]].

			Findings on [[ECG]] associated with [[ sudden cardiac arrest]] ([[SCA]]) may include:<ref name="JayaramanReinier2018">{{cite journal\|last1=Jayaraman\|first1=Reshmy\|last2=Reinier\|first2=Kyndaron\|last3=Nair\|first3=Sandeep\|last4=Aro\|first4=Aapo L.\|last5=Uy-Evanado\|first5=Audrey\|last6=Rusinaru\|first6=Carmen\|last7=Stecker\|first7=Eric C.\|last8=Gunson\|first8=Karen\|last9=Jui\|first9=Jonathan\|last10=Chugh\|first10=Sumeet S.\|title=Risk Factors of Sudden Cardiac Death in the Young\|journal=Circulation\|volume=137\|issue=15\|year=2018\|pages=1561–1570\|issn=0009-7322\|doi=10.1161/CIRCULATIONAHA.117.031262}}</ref>

	* [[Sinus tachycardia]] (39%)		* [[Sinus tachycardia]] (39%)
	* Abnormal [[T-wave inversions]] (30%)		* Abnormal [[T-wave inversions]] (30%)
	* Prolonged [[QT]] interval (26%)		* Prolonged [[QT]] interval
			* Long QT syndrome (26%) (present in 13% of young adults resuscitated from sudden cardiac arrest)<ref name=":0">Krahn AD, Healey JS, Chauhan V, et al. Systematic assessment of patients with unexplained cardiac arrest: Cardiac Arrest Survivors With Preserved Ejection Fraction Registry (CASPER). Circulation. 2009;120(4):278-285. doi:10.1161/CIRCULATIONAHA.109.853143</ref>
	* Left/[[right atrial]] abnormality (22%)		* Left/[[right atrial]] abnormality (22%)
	* [[ LVH]] (17%)		* [[ LVH]] (17%)
	* Abnormal frontal [[QRS axis]] (17%)		* Abnormal frontal [[QRS axis]] (17%)
	* Delayed [[QRS]]-transition zone in precordial leads (13%)		* Delayed [[QRS]]-transition zone in precordial leads (13%)
	* Pathological [[Q waves]] (13%)		* Pathological [[Q waves]] (13%)
	* [[intraventricular conduction delays]] (9%)		* [[intraventricular conduction delays]] (9%)
			* Wolff-Parkinson-White syndrome(5%-12% of young adults with cardiac arrest)<ref name=":0" />,<ref>van der Werf C, Hofman N, Tan HL, et al. Diagnostic yield in sudden unexplained death and aborted cardiac arrest in the young: the experience of a tertiary referral center in the Netherlands. Heart Rhythm.2010;7(10):1383-1389. doi:10.1016/j. hrthm.2010.05.036</ref>
			* Arrhythmogenic right ventricular cardiomyopathy(10% of young adults with cardiac arrest)<ref name=":0" />
			* Brugada syndrome (<1%).<ref>Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006.Circulation. 2009;119 (8):1085-1092. doi:10.1161/CIRCULATIONAHA.108.804617</ref>
	* Multiple [[premature ventricular contractions]] (9%)		* Multiple [[premature ventricular contractions]] (9%)
	* Normal [[ECG]] (9%)		* Normal [[ECG]] (9%)
			* If the ECG shows STEMI or unstable arrhythmia, the patient should be referred for emergency coronary angiography followed by revascularization in case of acute ischemia.

	A recently published case report demonstrated a [[cardiac arrest]] happening due to a very unusual cause. It was triggered by the increased [[parasympathethic tone]] during defecation. The successive changes that were observed on [[ECG]] were in this order: [[prolonged PR interval]], [[2:1 atrioventricular block]], [[sinus bradycardia]] and [[complete heart block]]. These findings supported the occurrence of a central mechanism in this cardiac arrest.<ref name="pmid33464284">{{cite journal\| author=Tsushima T, Patel TR, Sahadevan J\| title=Unusual Cause of Cardiac Arrest. \| journal=JAMA Intern Med \| year= 2021 \| volume= 181 \| issue= 4 \| pages= 542-543 \| pmid=33464284 \| doi=10.1001/jamainternmed.2020.8370 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33464284 }} </ref>		A recently published case report demonstrated a [[cardiac arrest]] happening due to a very unusual cause. It was triggered by the increased [[parasympathethic tone]] during defecation. The successive changes that were observed on [[ECG]] were in this order: [[prolonged PR interval]], [[2:1 atrioventricular block]], [[sinus bradycardia]] and [[complete heart block]]. These findings supported the occurrence of a central mechanism in this cardiac arrest.<ref name="pmid33464284">{{cite journal\| author=Tsushima T, Patel TR, Sahadevan J\| title=Unusual Cause of Cardiac Arrest. \| journal=JAMA Intern Med \| year= 2021 \| volume= 181 \| issue= 4 \| pages= 542-543 \| pmid=33464284 \| doi=10.1001/jamainternmed.2020.8370 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33464284 }} </ref>


			Repeating 12 lead ECGs are important during evaluation because ECG wave forms, particularly type 1 waveform in Brugada syndrome<ref>Curcio A, Mazzanti A, Bloise R, et al.Clinical presentation and outcome of Brugada syndrome diagnosed with the new 2013 criteria. JCardiovasc Electrophysiol. 2016;27(8):937-943. doi:10.1111/jce. 12997</ref> and the QTinterval, may show day-to-day and circadian variation<ref>Jeyaraj D, Haldar SM, Wan X, et al.Circadian rhythms govern cardiac repolarization and arrhythmogenesis. Nature. 2012;483(7387):96-99. doi:10.1038/nature10852</ref> and variation after the initial resuscitation due to ischemia, autonomic fluctuations, and electrolyte derangements (eg, hypokalemia, hypomagnesemia) after sudden cardiac arrest.<ref>Salerno DM, Asinger RW, Elsperger J, Ruiz E, Hodges M. Frequency of hypokalemia after successfully resuscitated out-of-hospital cardiac arrest compared with that in transmural acute myocardial infarction. Am J Cardiol. 1987;59(1):84 88. doi:10.1016/S0002-9149(87)80075-9</ref>

			== Long QT syndrome: ==
			Patients should be evaluated for LQTS, if the corrected QT interval remains at 460 milliseconds or longer for females or 450 milliseconds or longer for males<ref>Vink AS, Neumann B, Lieve KVV, et al. Determination and interpretation of the QT interval. Circulation. 2018;138(21):2345-2358. doi:10.1161/CIRCULATIONAHA.118.033943</ref> beyond 6 days after resuscitation.<ref>Cohen RB, Dai M, Aizer A, et al. QT interval dynamics and triggers for QTprolongation immediately following cardiac arrest. Resuscitation. 2021;162:171-179. doi:10.1016/j.resuscitation.2021.02. 029</ref> It is the most common arrhythmia syndrome causing sudden cardiac arrest.<ref name=":0" /> In patients with LQTS, a prolonged QT interval results in the end of the T wave often exceeding half of the RR interval,along with broad,biphasic,or notched T waves with beat-to-beat alternans.<ref>Krahn AD, Laksman Z, Sy RW, et al.Congenital long QT syndrome.JACCClinElectrophysiol. 2022;8 (5):687-706. doi:10.1016/j.jacep.2022.02.017</ref> In a study of 647 untreated patients older than 28 years with LQTS, 13% experienced out-of-hospital cardiac arrest or sudden death before age 40 years.<ref>Priori SG, Schwartz PJ, Napolitano C, et al. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348(19):1866-1874. doi:10.1056/ NEJMoa022147</ref> LQTS can be either congenital or acquired, most commonly due to drugs such as antiarrhythmics,antipsychotics,antidepressants,or antibiotics (a continuously updated list can be found at https://crediblemeds.org/). However, some acquired LQTS cases may have underlying congenital LQTS unmasked by drugs or other predisposing factors such as electrolyte abnormalities (hypokalemia, hypomagnesemia, and hypocalcemia) or bradyarrhythmias. Evaluation for acquired LQTS should be reassessed after resolution of these factors.<ref>Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al; ESC Scientific Document Group. 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. EurHeartJ. 2022;43(40): 3997-4126. doi:10.1093/eurheartj/ehac262</ref>

			== Brugada syndrome: ==
			In Brugada syndrome, type 1 pattern (ie,coved shape of ST segment) in leads V1 and V2 can sometimes be recorded when these leads are moved to the second or third intercostal spaces instead of the typical fourth intercostal space.<ref>Zeppenfeld K,Tfelt-Hansen J, de Riva M, et al; ESC Scientific Document Group. 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. EurHeartJ. 2022;43(40): 3997-4126. doi:10.1093/eurheartj/ehac262</ref> In preexcitation syndromes (ie,Wolff-Parkinson-White), the observed delta waves are a marker for potential atrioventricular reentrant tachycardia or VF via preexcited atrial fibrillation.<ref>Pappone C, Vicedomini G, Manguso F, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130(10):811-819. doi:10.1161/CIRCULATIONAHA.114.011154</ref> In some cases of arrhythmogenic right ventricular cardiomyopathy, epsilon waves that represent delayed right ventricular conduction can be observed in the ST segment in the right precordial leads.<ref>Marcus FI, Fontaine GH, Guiraudon G, et al. Right ventricular dysplasia: a report of 24 adult cases. Circulation. 1982;65(2):384-398. doi:10.1161/ 01.CIR.65.2.384</ref>

	==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==		==2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death <ref name="pmid36017572">{{cite journal\| author=Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA \| display-authors=etal\| title=2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. \| journal=Eur Heart J \| year= 2022 \| volume= 43 \| issue= 40 \| pages= 3997-4126 \| pmid=36017572 \| doi=10.1093/eurheartj/ehac262 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36017572 }} </ref>==

Sudden cardiac death diagnostic study of choice

2026-04-04T10:00:39Z

Overview

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	==Overview==		==Overview==
			In resuscitated sudden cardiac arrest individuals, an emergency workup should be performed, it includes:

			# 12-lead electrocardiogram (ECG)
			# Toxicology testing
			# Bedside neurological assessment
			# Neuroimaging (eg, head computed tomography [CT]) after the patient has stabilized.

	According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.		According to the 2017 Association for European Cardiovascular Pathologists guidelines, [[autopsy]] is done whenever [[sudden cardiac death]] ([[SCD]]) is suspected.

Sudden cardiac death epidemiology and demographics

2026-04-04T09:29:56Z

Age

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	===Age===		===Age===
	* There is a low [[incidence]] of [[SCD]] in [[infants]] and [[children]] which is approximately 1 per 100,000 person-years.		* There is a low [[incidence]] of [[SCD]] in [[infants]] and [[children]] which is approximately 1 per 100,000 person-years.
			* In adults younger than 40 years, the worldwide incidence of presumed sudden cardiac death is 4.2 to 7.8 per 100000 person-years.<ref name=":1">Zhang J, Zhou X, Xing Q,et al.Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomousregion in Northwest China. BMCPublicHealth. 2019;19(1):116. doi:10. 1186/s12889-019-6435-8</ref><ref name=":2">Tseng ZH, Olgin JE, Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCDstudy.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref><ref name=":3">Empana JP, Lerner I, Valentin E, et al; ESCAPE-NET Investigators. Incidence of sudden cardiac death in the EuropeanUnion.JAmColl Cardiol. 2022;79(18):1818-1827. doi:10.1016/j.jacc. 2022.02.041</ref><ref name=":4">Hua W, Zhang LF, Wu YF, et al.Incidence of sudden cardiac death in China:analysis of 4 regional populations. J Am Coll Cardiol. 2009;54 (12):1110-1118. doi:10.1016/j.jacc.2009.06.016</ref><ref name=":5">Hendrix A, Vaartjes I, Mosterd A, et al. Regional differences in incidence of sudden cardiac death in the young.NethJMed.2010;68(6):274-279.</ref>
			* In adults aged 40 through 49 years, the worldwide incidence of presumed sudden cardiac death is 23 to 34 per 100000 person-years.<ref name=":1" /><ref name=":2" /><ref name=":3" /><ref name=":4" /><ref name=":5" />
	* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.		* The [[incidence]] of [[SCD]] in middle-aged people (50 to 60 years old) is around 50 per 1000,000 person-years.
	* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.		* Among people in their eight decade of life, [[incidence]] of [[SCD]] approximates about 200 per 100,000 person-years <ref name="pmid24610738">{{cite journal\| author=Stecker EC, Reinier K, Marijon E, Narayanan K, Teodorescu C, Uy-Evanado A \| display-authors=etal\| title=Public health burden of sudden cardiac death in the United States. \| journal=Circ Arrhythm Electrophysiol \| year= 2014 \| volume= 7 \| issue= 2 \| pages= 212-7 \| pmid=24610738 \| doi=10.1161/CIRCEP.113.001034 \| pmc=4041478 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24610738 }} </ref>.
			* Among autopsy studies of persons younger than age 30 years who had sudden cardiac death, the most common cause was sudden arrhythmic death syndrome with normal heart on postmort emexamination (36%-49%).<ref name=":6">Bagnall RD, Weintraub RG, Ingles J, et al. A prospective study of sudden cardiac death among children and young adults. NEnglJMed.2016;374 (25):2441-2452. doi:10.1056/NEJMoa1510687</ref><ref name=":7">Wisten A, Krantz P, Stattin EL. Sudden cardiac death among the young in Sweden from 2000 to 2010: an autopsy-based study. Europace.2017;19 (8):1327-1334.</ref>
			* The proportion of cases attributable to CAD increased with age, from 6% to 14% in persons younger than 30 years and to 19% to 46% in persons aged 30 years or older.<ref name=":6" />,<ref name=":7" />,<ref name="pmid21131293" />,<ref>Lynge TH, Nielsen JL, Risgaard B, van der Werf C, Winkel BG, Tfelt-Hansen J. Causes of sudden cardiac death according to age and sex in persons aged1-49 years. HeartRhythm.2023;20(1):61-68. doi:10.1016/j.hrthm.2022.08.036</ref>
			* Unexpected myocarditis is another relatively common underlying cause of sudden cardiac death in young adults.<ref name=":6" />,<ref name=":7" />,<ref name="pmid21131293" />
			* Autopsy-confirmed dilated cardiomyopathy was more frequently identified among individuals who were older than 30 years (10%) than individuals who were younger than 30 years (5%).<ref name=":6" />,<ref name=":7" />
			* Autopsy-based studies of individuals with sudden cardiac death aged 18 to 50 years reported that 65% to 78% had at least one known cardiovascular disease (CVD) risk factor (ie, hypertension, diabetes,dyslipidemia,obesity,smoking) before death.<ref name=":2" />,<ref>Vähätalo J, Holmström L, Pakanen L, et al. Coronary artery disease as the cause of sudden cardiac death among victims <50 years of age.Am J Cardiol. 2021;147:33-38. doi:10.1016/j.amjcard. 2021.02.012</ref> In these studies, compared with the reported prevalence of individual risk factors in the general US population among those aged 20 through 44 years,<ref>Aggarwal R, Yeh RW, Joynt Maddox KE, Wadhera RK. Cardiovascular risk factor prevalence, treatment, and control in us adults aged 20 to 44 years, 2009 to March 2020.JAMA.2023;329(11): 899-909.doi:10.1001/jama.2023.2307</ref> the reported prevalence of hypertension and diabetes was higher among those with sudden cardiac death (22%-24% vs 12% and 12% - 19% vs 4%, respectively).

	===Gender===		===Gender===

	*commonly affected with [[sudden cardiac death]] than [[women]] in all age groups.<ref name="EckartShry2011">{{cite journal\|last1=Eckart\|first1=Robert E.\|last2=Shry\|first2=Eric A.\|last3=Burke\|first3=Allen P.\|last4=McNear\|first4=Jennifer A.\|last5=Appel\|first5=David A.\|last6=Castillo-Rojas\|first6=Laudino M.\|last7=Avedissian\|first7=Lena\|last8=Pearse\|first8=Lisa A.\|last9=Potter\|first9=Robert N.\|last10=Tremaine\|first10=Ladd\|last11=Gentlesk\|first11=Philip J.\|last12=Huffer\|first12=Linda\|last13=Reich\|first13=Stephen S.\|last14=Stevenson\|first14=William G.\|title=Sudden Death in Young Adults\|journal=Journal of the American College of Cardiology\|volume=58\|issue=12\|year=2011\|pages=1254–1261\|issn=07351097\|doi=10.1016/j.jacc.2011.01.049}}</ref>		*Men commonly affected with [[sudden cardiac death]] than [[women]] in all age groups.<ref name="EckartShry2011">{{cite journal\|last1=Eckart\|first1=Robert E.\|last2=Shry\|first2=Eric A.\|last3=Burke\|first3=Allen P.\|last4=McNear\|first4=Jennifer A.\|last5=Appel\|first5=David A.\|last6=Castillo-Rojas\|first6=Laudino M.\|last7=Avedissian\|first7=Lena\|last8=Pearse\|first8=Lisa A.\|last9=Potter\|first9=Robert N.\|last10=Tremaine\|first10=Ladd\|last11=Gentlesk\|first11=Philip J.\|last12=Huffer\|first12=Linda\|last13=Reich\|first13=Stephen S.\|last14=Stevenson\|first14=William G.\|title=Sudden Death in Young Adults\|journal=Journal of the American College of Cardiology\|volume=58\|issue=12\|year=2011\|pages=1254–1261\|issn=07351097\|doi=10.1016/j.jacc.2011.01.049}}</ref>
			*In a study of sudden cardiac death in young adults (n =2006,median age, 28 years), CAD was more common in males (44%) than in females (27%), whereas unspecified cardiomyopathy (5% males vs 7% females, P = .04), myocarditis (9% males vs 14% females,P < .001), and valvular heart disease (2% males vs 7% females,P < .001) were more common in young females.<ref>Ha FJ, Han HC, Sanders P, et al. Sudden cardiac death in the young:incidence, trends, and risk factors in a nationwide study. Circ Cardiovasc Qual Outcomes. 2020;13(10):e006470.doi:10.1161/ CIRCOUTCOMES.119.006470</ref>

	===Race===		===Race===
	*[[Black]] individuals are more likely to develop [[cardiac arrest]].<ref name="BeckerHan1993">{{cite journal\|last1=Becker\|first1=Lance B.\|last2=Han\|first2=Ben H.\|last3=Meyer\|first3=Peter M.\|last4=Wright\|first4=Fred A.\|last5=Rhodes\|first5=Karin V.\|last6=Smith\|first6=David W.\|last7=Barrett\|first7=John\|title=Racial Differences in the Incidence of Cardiac Arrest and Subsequent Survival\|journal=New England Journal of Medicine\|volume=329\|issue=9\|year=1993\|pages=600–606\|issn=0028-4793\|doi=10.1056/NEJM199308263290902}}</ref>		*[[Black]] individuals are more likely to develop [[cardiac arrest]].<ref name="BeckerHan1993">{{cite journal\|last1=Becker\|first1=Lance B.\|last2=Han\|first2=Ben H.\|last3=Meyer\|first3=Peter M.\|last4=Wright\|first4=Fred A.\|last5=Rhodes\|first5=Karin V.\|last6=Smith\|first6=David W.\|last7=Barrett\|first7=John\|title=Racial Differences in the Incidence of Cardiac Arrest and Subsequent Survival\|journal=New England Journal of Medicine\|volume=329\|issue=9\|year=1993\|pages=600–606\|issn=0028-4793\|doi=10.1056/NEJM199308263290902}}</ref>
			*Incidence of presumed sudden cardiac death among adults younger than 40 years in Cameroon was higher at 12 to 42 per 100000 person-years.<ref>Bonny A,Tibazarwa K, Mbouh S, et al; PanAfrican Society of Cardiology (PASCAR) Task Force on Sudden Cardiac Death.Epidemiology of sudden cardiac death in Cameroon:the first population-based cohort survey in sub-Saharan Africa. Int J Epidemiol. 2017;46(4):1230-1238. doi:10.1093/ije/dyx043</ref>
			*In a US study from 1999 through 2015 (n = 31492), Black individuals younger than 34 years had a higher incidence of presumed sudden cardiac deaths (1.88 per 100000 person-years in 2015) than Hispanic individuals (0.66 per 100000 person-years),and White individuals (1.17 per 100000 person-years),<ref>El-AssaadI, Al-Kindi SG, Aziz PF. Trends of out-of-hospital sudden cardiac death among children and youngadults. Pediatrics. 2017;140(6): e20171438. doi:10.1542/peds.2017-1438</ref> which may be due to inequitable access to care <ref>Noonan AS, Velasco-Mondragon HE, Wagner FA. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev. 2016;37:12. doi:10. 1186/s40985-016-0025-4</ref> and racial disparities among out-of hospital resuscitation attempts.
			*White individuals were more likely to receive bystander CPR after a witnessed cardiac arrest and postresuscitation care than were Black and Hispanic persons in several US based studies.<ref>Toy J, Bosson N, Schlesinger S,Gausche-Hill M. Racial and ethnic disparities in the provision of bystander CPR after witnessed out-of-hospital cardiac arrest in the United States. Resuscitation. 2023;190:109901. doi:10.1016/j.resuscitation.2023. 109901</ref><ref>Casey SD, Mumma BE.Sex,race,and insurance status differences in hospital treatment and outcomes following out-of-hospital cardiac arrest. Resuscitation. 2018;126:125-129. doi:10.1016/j. resuscitation.2018.02.027</ref>

	==References==		==References==

Sudden cardiac versus non-cardiac death

2026-04-02T02:57:45Z

References

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Acute lymphoblastic leukemia medical therapy

2026-03-29T23:42:06Z

Flowchart:

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 *Maintenance treatment
 *Follow-up therapy
 ==Induction chemotherapy==

Sudden cardiac versus non-cardiac death

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Show changes

Sudden cardiac death pathophysiology

2026-03-29T01:23:47Z

Pathophysiology

← Older revision		Revision as of 01:23, 29 March 2026
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{Jose}} {{EdzelCo}} {{Nehal}}
	==Overview==		==Overview==
	The pathogenesis of [[cardiac arrest]] is characterized by the [[myocardial]] [[inflammatory process]] in the setting of [[atherosclerosis]], [[structural heart disease]], [[genetic disorders]], and environmental factors. The [[SCN5A]], [[KCNH2]], [[KCNQ1]], [[RYR2]], [[MYBPC3]], [[PKP2]], [[DSP]] [[genes mutation]] are associated with the development of inherited causes of [[cardiac arrest]] and [[sudden cardiac death]].		The pathogenesis of [[cardiac arrest]] is characterized by the [[myocardial]] [[inflammatory process]] in the setting of [[atherosclerosis]], [[structural heart disease]], [[genetic disorders]], and environmental factors. The [[SCN5A]], [[KCNH2]], [[KCNQ1]], [[RYR2]], [[MYBPC3]], [[PKP2]], [[DSP]] [[genes mutation]] are associated with the development of inherited causes of [[cardiac arrest]] and [[sudden cardiac death]].

	==Pathophysiology==		==Pathophysiology==
	*~~The [[pathogenesis]]~~ of [[cardiac arrest~~]] is characterized~~ by the ~~[[myocardial]] [[inflammatory process]]~~ in the ~~setting~~ of ~~[[atherosclerosis]]~~, [[structural heart disease]], ~~[[genetic~~ disorders]], and ~~[[environmental factors]]~~.		*Arrhythmias that cease cardiac mechanical activity<ref>Nichol G,Rumsfeld J,Eigel B,et al; American Heart Association Emergency Cardiovascular Care Committee;American Heart Association Council on Cardiopulmonary, Perioperative, and Critical Care; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; Quality of Care and Outcomes Research Interdisciplinary Working Group.Essential features of designating out-of-hospital cardiac arrest as a reportable event: a scientific statement from the American Heart Association Emergency Cardiovascular Care Committee;Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2008;117(17):2299-2308. doi:10.1161/ CIRCULATIONAHA.107.189472</ref> include tachyarrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation(VF),and bradyarrhythmias.Such arrythmias are acutely reversible with defibrillation or pacing and may be caused by myocardial injury via acquired cardiac disease (eg, ischemia, inflammation, pressure overload), inherited cardiac disease (eg, arrhythmia syndromes and structural heart diseases), acute electrolyte imbalance(eg,hyperkalemia due to kidney failure),or autonomic dysregulation.
			*Approximately 10% of persons who have had outside the hospital cardiac arrests have pulseless electrical activity,<ref>KitamuraT,Iwami T,Nichol G,et al;Utstein Osaka Project. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010;31(11):1365-1372. doi:10.1093/eurheartj/ehq059</ref> defined by absence of palpable pulse in an unconscious person with organized electrical activity other than VT or VF on ECG<ref>Myerburg RJ,Halperin H,Egan DA,et al. Pulseless electric activity: definition, causes, mechanisms,management,and research priorities for the next decade:report from a NationalHeart, Lung, and BloodI nstitute workshop. Circulation. 2013;128(23):2532-2541. doi:10.1161/ CIRCULATIONAHA.113.004490</ref>. Possible underlying causes include acute heart failure, cardiac tamponade, acidosis, hemorrhage, hypoxia, or tension pneumothorax. Asystole is characterized by complete absence of electrical and mechanical cardiac activity.
			*These terminal rhythms can be due to:
			*Unrecognized underlying structural heart disease such as CAD or cardiomyopathy, arrhythmia syndromes such as long QT syndrome(LQTS) or Brugada syndrome, and conditions that predispose to arrhythmias such as muscular dystrophies<ref>Groh WJ,Groh MR,Saha C,et al. Electrocardiographic abnormalities and sudden death in myotonic dystrophy type1.N Engl J Med. 2008;358(25):2688-2697.doi:10.1056/ NEJMoa062800</ref>
			*Noncardiac conditions such as neurocardiogenic VF due to intracranial hemorrhage,<ref>Kim AS,Moffatt E,Ursell PC,Devinsky O, Olgin J, Tseng ZH.Sudden neurologic death masquerading as out-of-hospital sudden cardiac death. Neurology. 2016;87(16):1669-1673. doi:10. 1212/WNL.0000000000003238</ref>bradyarrhythmias secondary to opioid overdose,<ref>Tseng ZH,Olgin JE,Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCD study.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref>and serum electrolyte disorders.<ref>Siscovick DS, RaghunathanTE,Psaty BM,et al. Diuretic therapy for hypertension and the risk of primary cardiac arrest. N Engl J Med. 1994;330(26): 1852-1857. doi:10.1056/NEJM199406303302603</ref>
			*Opioids, stimulants (eg, cocaine), or supplements (eg,herbal medications,energy drinks)<ref>Liperoti R, Vetrano DL,BernabeiR,OnderG. Herbal medications in cardiovascular medicine. J AmCollCardiol. 2017;69(9):1188-1199. doi:10. 1016/j.jacc.2016.11.078</ref><ref>Shah SA,Szeto AH,Farewell R,et al.Impact of high volume energy drink consumptionon electrocardiographic and blood pressure parameters: a randomized trial. J AmHeartAssoc. 2019;8(11):e011318. doi:10.1161/JAHA.118.011318</ref>can also cause sudden cardiac arrest via QT prolongation,<ref>Orkin AM,Zhan C,Buick JE,et al. Out-of-hospital cardiac arrest survival in drug-related versus cardiac causes in Ontario: a retrospective cohort study. PLoS One. 2017;12(4): e0176441. doi:10.1371/journal.pone.0176441</ref> predisposing to polymorphic VT, also called torsades de pointes.
			*Congenital conditions such as anomalous coronary artery origin with a course between the aorta and pulmonary artery can predispose to cardiac arrest via myocardial ischemia.<ref>Gentile F, Castiglione V, De Caterina R. Coronary artery anomalies. Circulation. 2021;144 (12):983-996. doi:10.1161/CIRCULATIONAHA.121. 055347</ref>
	*The [[SCN5A]], [[KCNH2]], [[KCNQ1]], [[RYR2]], [[MYBPC3]], [[PKP2]], [[DSP]] [[genes mutation]] are associated with the development of inherited causes of [[cardiac arrest]] and [[sudden cardiac death]].<ref name="OsmanTan2019">{{cite journal\|last1=Osman\|first1=Junaida\|last2=Tan\|first2=Shing Cheng\|last3=Lee\|first3=Pey Yee\|last4=Low\|first4=Teck Yew\|last5=Jamal\|first5=Rahman\|title=Sudden Cardiac Death (SCD) – risk stratification and prediction with molecular biomarkers\|journal=Journal of Biomedical Science\|volume=26\|issue=1\|year=2019\|issn=1423-0127\|doi=10.1186/s12929-019-0535-8}}</ref><ref name="MehtaCurwin1997">{{cite journal\|last1=Mehta\|first1=Davendra\|last2=Curwin\|first2=Jay\|last3=Gomes\|first3=J. Anthony\|last4=Fuster\|first4=Valentin\|title=Sudden Death in Coronary Artery Disease\|journal=Circulation\|volume=96\|issue=9\|year=1997\|pages=3215–3223\|issn=0009-7322\|doi=10.1161/01.CIR.96.9.3215}}</ref><ref name="Akhtar1991">{{cite journal\|last1=Akhtar\|first1=Masood\|title=Sudden Cardiac Death: Management of High-Risk Patients\|journal=Annals of Internal Medicine\|volume=114\|issue=6\|year=1991\|pages=499\|issn=0003-4819\|doi=10.7326/0003-4819-114-6-499}}</ref>		*The [[SCN5A]], [[KCNH2]], [[KCNQ1]], [[RYR2]], [[MYBPC3]], [[PKP2]], [[DSP]] [[genes mutation]] are associated with the development of inherited causes of [[cardiac arrest]] and [[sudden cardiac death]].<ref name="OsmanTan2019">{{cite journal\|last1=Osman\|first1=Junaida\|last2=Tan\|first2=Shing Cheng\|last3=Lee\|first3=Pey Yee\|last4=Low\|first4=Teck Yew\|last5=Jamal\|first5=Rahman\|title=Sudden Cardiac Death (SCD) – risk stratification and prediction with molecular biomarkers\|journal=Journal of Biomedical Science\|volume=26\|issue=1\|year=2019\|issn=1423-0127\|doi=10.1186/s12929-019-0535-8}}</ref><ref name="MehtaCurwin1997">{{cite journal\|last1=Mehta\|first1=Davendra\|last2=Curwin\|first2=Jay\|last3=Gomes\|first3=J. Anthony\|last4=Fuster\|first4=Valentin\|title=Sudden Death in Coronary Artery Disease\|journal=Circulation\|volume=96\|issue=9\|year=1997\|pages=3215–3223\|issn=0009-7322\|doi=10.1161/01.CIR.96.9.3215}}</ref><ref name="Akhtar1991">{{cite journal\|last1=Akhtar\|first1=Masood\|title=Sudden Cardiac Death: Management of High-Risk Patients\|journal=Annals of Internal Medicine\|volume=114\|issue=6\|year=1991\|pages=499\|issn=0003-4819\|doi=10.7326/0003-4819-114-6-499}}</ref>

Sudden cardiac death epidemiology and demographics

2026-03-29T00:43:53Z

Epidemiology and demographics

← Older revision		Revision as of 00:43, 29 March 2026
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	* The [[prevalence]] of [[sudden cardiac death]] is approximately 1.40 per 100,000 individuals in women to 6.68 per 100.000 individuals in men worldwide.<ref name="PrioriBlomström-Lundqvist2015">{{cite journal\|last1=Priori\|first1=Silvia G.\|last2=Blomström-Lundqvist\|first2=Carina\|last3=Mazzanti\|first3=Andrea\|last4=Blom\|first4=Nico\|last5=Borggrefe\|first5=Martin\|last6=Camm\|first6=John\|last7=Elliott\|first7=Perry Mark\|last8=Fitzsimons\|first8=Donna\|last9=Hatala\|first9=Robert\|last10=Hindricks\|first10=Gerhard\|last11=Kirchhof\|first11=Paulus\|last12=Kjeldsen\|first12=Keld\|last13=Kuck\|first13=Karl-Heinz\|last14=Hernandez-Madrid\|first14=Antonio\|last15=Nikolaou\|first15=Nikolaos\|last16=Norekvål\|first16=Tone M.\|last17=Spaulding\|first17=Christian\|last18=Van Veldhuisen\|first18=Dirk J.\|title=2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death\|journal=European Heart Journal\|volume=36\|issue=41\|year=2015\|pages=2793–2867\|issn=0195-668X\|doi=10.1093/eurheartj/ehv316}}</ref>		* The [[prevalence]] of [[sudden cardiac death]] is approximately 1.40 per 100,000 individuals in women to 6.68 per 100.000 individuals in men worldwide.<ref name="PrioriBlomström-Lundqvist2015">{{cite journal\|last1=Priori\|first1=Silvia G.\|last2=Blomström-Lundqvist\|first2=Carina\|last3=Mazzanti\|first3=Andrea\|last4=Blom\|first4=Nico\|last5=Borggrefe\|first5=Martin\|last6=Camm\|first6=John\|last7=Elliott\|first7=Perry Mark\|last8=Fitzsimons\|first8=Donna\|last9=Hatala\|first9=Robert\|last10=Hindricks\|first10=Gerhard\|last11=Kirchhof\|first11=Paulus\|last12=Kjeldsen\|first12=Keld\|last13=Kuck\|first13=Karl-Heinz\|last14=Hernandez-Madrid\|first14=Antonio\|last15=Nikolaou\|first15=Nikolaos\|last16=Norekvål\|first16=Tone M.\|last17=Spaulding\|first17=Christian\|last18=Van Veldhuisen\|first18=Dirk J.\|title=2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death\|journal=European Heart Journal\|volume=36\|issue=41\|year=2015\|pages=2793–2867\|issn=0195-668X\|doi=10.1093/eurheartj/ehv316}}</ref>
	* In 2015, the incidence of adult in-hospital [[cardiac arrests]] was estimated to be 970 cases per 100,000 individuals in the United States.<ref name="HolmbergRoss2019">{{cite journal\|last1=Holmberg\|first1=Mathias J.\|last2=Ross\|first2=Catherine E.\|last3=Fitzmaurice\|first3=Garrett M.\|last4=Chan\|first4=Paul S.\|last5=Duval-Arnould\|first5=Jordan\|last6=Grossestreuer\|first6=Anne V.\|last7=Yankama\|first7=Tuyen\|last8=Donnino\|first8=Michael W.\|last9=Andersen\|first9=Lars W.\|last10=Chan\|first10=Paul\|last11=Grossestreuer\|first11=Anne V.\|last12=Moskowitz\|first12=Ari\|last13=Edelson\|first13=Dana\|last14=Ornato\|first14=Joseph\|last15=Berg\|first15=Katherine\|last16=Peberdy\|first16=Mary Ann\|last17=Churpek\|first17=Matthew\|last18=Kurz\|first18=Michael\|last19=Starks\|first19=Monique Anderson\|last20=Girotra\|first20=Saket\|last21=Perman\|first21=Sarah\|last22=Goldberger\|first22=Zachary\|last23=Guerguerian\|first23=Anne-Marie\|last24=Atkins\|first24=Dianne\|last25=Foglia\|first25=Elizabeth\|last26=Fink\|first26=Ericka\|last27=Lasa\|first27=Javier J.\|last28=Roberts\|first28=Joan\|last29=Bembea\|first29=Melanie\|last30=Gaies\|first30=Michael\|last31=Kleinman\|first31=Monica\|last32=Gupta\|first32=Punkaj\|last33=Sutton\|first33=Robert\|last34=Sawyer\|first34=Taylor\|title=Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States\|journal=Circulation: Cardiovascular Quality and Outcomes\|volume=12\|issue=7\|year=2019\|issn=1941-7713\|doi=10.1161/CIRCOUTCOMES.119.005580}}</ref>		* In 2015, the incidence of adult in-hospital [[cardiac arrests]] was estimated to be 970 cases per 100,000 individuals in the United States.<ref name="HolmbergRoss2019">{{cite journal\|last1=Holmberg\|first1=Mathias J.\|last2=Ross\|first2=Catherine E.\|last3=Fitzmaurice\|first3=Garrett M.\|last4=Chan\|first4=Paul S.\|last5=Duval-Arnould\|first5=Jordan\|last6=Grossestreuer\|first6=Anne V.\|last7=Yankama\|first7=Tuyen\|last8=Donnino\|first8=Michael W.\|last9=Andersen\|first9=Lars W.\|last10=Chan\|first10=Paul\|last11=Grossestreuer\|first11=Anne V.\|last12=Moskowitz\|first12=Ari\|last13=Edelson\|first13=Dana\|last14=Ornato\|first14=Joseph\|last15=Berg\|first15=Katherine\|last16=Peberdy\|first16=Mary Ann\|last17=Churpek\|first17=Matthew\|last18=Kurz\|first18=Michael\|last19=Starks\|first19=Monique Anderson\|last20=Girotra\|first20=Saket\|last21=Perman\|first21=Sarah\|last22=Goldberger\|first22=Zachary\|last23=Guerguerian\|first23=Anne-Marie\|last24=Atkins\|first24=Dianne\|last25=Foglia\|first25=Elizabeth\|last26=Fink\|first26=Ericka\|last27=Lasa\|first27=Javier J.\|last28=Roberts\|first28=Joan\|last29=Bembea\|first29=Melanie\|last30=Gaies\|first30=Michael\|last31=Kleinman\|first31=Monica\|last32=Gupta\|first32=Punkaj\|last33=Sutton\|first33=Robert\|last34=Sawyer\|first34=Taylor\|title=Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States\|journal=Circulation: Cardiovascular Quality and Outcomes\|volume=12\|issue=7\|year=2019\|issn=1941-7713\|doi=10.1161/CIRCOUTCOMES.119.005580}}</ref>
	* Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100000 person-years worldwide.<ref ~~name=":0"~~>~~Tseng ZH~~, ~~Nakasuka K~~. ~~Out~~-of~~-Hospital Cardiac Arrest in Apparently Healthy, Young Adults~~. ~~''JAMA~~.~~'' 2025~~;~~333~~(11):~~981–996~~. doi:10.~~1001~~/~~jama~~.~~2024~~.~~27916~~</ref>		* Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100000 person-years worldwide.<ref>Meyer L,Stubbs B,Fahrenbruch C,et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and youngadults 0 to 35 years of age: a 30 year review.Circulation. 2012;126(11):1363-1372. doi:10.1161/CIRCULATIONAHA.111.076810</ref>
	* .Of an estimated 350,000 to 450,000 total annual out-of-hospital cardiac arrests in the US,approximately 10% survive.<ref>Tsao CW, Aday AW, Almarzooq ZI, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93-e621. doi:10.1161/CIR.0000000000001123</ref>		* .Of an estimated 350,000 to 450,000 total annual out-of-hospital cardiac arrests in the US,approximately 10% survive.<ref>Tsao CW, Aday AW, Almarzooq ZI, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93-e621. doi:10.1161/CIR.0000000000001123</ref>
	* Approximately 60% of young adults aged 18 through 39 years who experience cardiac arrest outside a hospital die before reaching the hospital. Overall, 9% to 16%survive, of whom 90% have favorable neurological outcomes<ref name=":0" />		* Approximately 60% of young adults aged 18 through 39 years who experience cardiac arrest outside a hospital die before reaching the hospital. Overall, 9% to 16%survive, of whom 90% have favorable neurological outcomes<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. ''JAMA.'' 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	* In some middle-aged males, sports is related to [[SCD]] which occurs more frequently in a recreational setting than a competition <ref name="pmid21788587">{{cite journal\| author=Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H \| display-authors=etal\| title=Sports-related sudden death in the general population. \| journal=Circulation \| year= 2011 \| volume= 124 \| issue= 6 \| pages= 672-81 \| pmid=21788587 \| doi=10.1161/CIRCULATIONAHA.110.008979 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21788587 }} </ref> <ref name="pmid30813818">{{cite journal\| author=Heidbuchel H, Willems R, Jordaens L, Olshansky B, Carre F, Lozano IF \| display-authors=etal\| title=Intensive recreational athletes in the prospective multinational ICD Sports Safety Registry: Results from the European cohort. \| journal=Eur J Prev Cardiol \| year= 2019 \| volume= 26 \| issue= 7 \| pages= 764-775 \| pmid=30813818 \| doi=10.1177/2047487319834852 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30813818 }} </ref>. In these instances, [[coronary artery disease]] ([[CAD]]) is the most common cause <ref name="pmid24861446">{{cite journal\| author=Risgaard B, Winkel BG, Jabbari R, Glinge C, Ingemann-Hansen O, Thomsen JL \| display-authors=etal\| title=Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. \| journal=Heart Rhythm \| year= 2014 \| volume= 11 \| issue= 10 \| pages= 1673-81 \| pmid=24861446 \| doi=10.1016/j.hrthm.2014.05.026 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24861446 }} </ref> <ref name="pmid23942684">{{cite journal\| author=Marijon E, Bougouin W, Périer MC, Celermajer DS, Jouven X\| title=Incidence of sports-related sudden death in France by specific sports and sex. \| journal=JAMA \| year= 2013 \| volume= 310 \| issue= 6 \| pages= 642-3 \| pmid=23942684 \| doi=10.1001/jama.2013.8711 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23942684 }} </ref><ref name="pmid25847988">{{cite journal\| author=Marijon E, Uy-Evanado A, Reinier K, Teodorescu C, Narayanan K, Jouven X \| display-authors=etal\| title=Sudden cardiac arrest during sports activity in middle age. \| journal=Circulation \| year= 2015 \| volume= 131 \| issue= 16 \| pages= 1384-91 \| pmid=25847988 \| doi=10.1161/CIRCULATIONAHA.114.011988 \| pmc=4406826 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25847988 }} </ref>.		* In some middle-aged males, sports is related to [[SCD]] which occurs more frequently in a recreational setting than a competition <ref name="pmid21788587">{{cite journal\| author=Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H \| display-authors=etal\| title=Sports-related sudden death in the general population. \| journal=Circulation \| year= 2011 \| volume= 124 \| issue= 6 \| pages= 672-81 \| pmid=21788587 \| doi=10.1161/CIRCULATIONAHA.110.008979 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21788587 }} </ref> <ref name="pmid30813818">{{cite journal\| author=Heidbuchel H, Willems R, Jordaens L, Olshansky B, Carre F, Lozano IF \| display-authors=etal\| title=Intensive recreational athletes in the prospective multinational ICD Sports Safety Registry: Results from the European cohort. \| journal=Eur J Prev Cardiol \| year= 2019 \| volume= 26 \| issue= 7 \| pages= 764-775 \| pmid=30813818 \| doi=10.1177/2047487319834852 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30813818 }} </ref>. In these instances, [[coronary artery disease]] ([[CAD]]) is the most common cause <ref name="pmid24861446">{{cite journal\| author=Risgaard B, Winkel BG, Jabbari R, Glinge C, Ingemann-Hansen O, Thomsen JL \| display-authors=etal\| title=Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. \| journal=Heart Rhythm \| year= 2014 \| volume= 11 \| issue= 10 \| pages= 1673-81 \| pmid=24861446 \| doi=10.1016/j.hrthm.2014.05.026 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24861446 }} </ref> <ref name="pmid23942684">{{cite journal\| author=Marijon E, Bougouin W, Périer MC, Celermajer DS, Jouven X\| title=Incidence of sports-related sudden death in France by specific sports and sex. \| journal=JAMA \| year= 2013 \| volume= 310 \| issue= 6 \| pages= 642-3 \| pmid=23942684 \| doi=10.1001/jama.2013.8711 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23942684 }} </ref><ref name="pmid25847988">{{cite journal\| author=Marijon E, Uy-Evanado A, Reinier K, Teodorescu C, Narayanan K, Jouven X \| display-authors=etal\| title=Sudden cardiac arrest during sports activity in middle age. \| journal=Circulation \| year= 2015 \| volume= 131 \| issue= 16 \| pages= 1384-91 \| pmid=25847988 \| doi=10.1161/CIRCULATIONAHA.114.011988 \| pmc=4406826 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25847988 }} </ref>.
			* Few worldwide data exist on outcomes following an event specifically in young adults. However, among 206 individuals aged 18 to 44 years who had arrested outside the hospital in Taiwan from 2017 to 2021,approximately 60% had sudden death(ie,presumed sudden cardiac death) and approximately 40% were resuscitated to hospitalization.<ref>Chen CY, Fan CY, Chen IC,et al.The interaction of sex and age on outcomes in emergency medical services-treated out-of-hospital cardiac arrest: a 5-year multicenter retrospective analysis. Resusc Plus. 2024;17:100552. doi:10.1016/j.resplu.2024.100552</ref>

	===Age===		===Age===

Sudden cardiac death other diagnostic studies

2026-03-29T00:35:14Z

Genetic testing

← Older revision		Revision as of 00:35, 29 March 2026
(One intermediate revision by the same user not shown)
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}


	==Overview==		==Overview==
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	===Genetic testing===		===Genetic testing===
	* ~~This test~~ is used to identify [[genetic]] composition of an individual and determine whether genetic variation modifications are present leading to [[Brugada syndrome]], [[long QT syndrome]] ([[LQTS]]), [[hypertrophic cardiomyopathy]] ([[HCM]]), and [[dilated cardiomyopathy]] ([[DCM]]) <ref name="pmid33831308">{{cite journal\| author=James CA, Jongbloed JDH, Hershberger RE, Morales A, Judge DP, Syrris P \| display-authors=etal\| title=International Evidence Based Reappraisal of Genes Associated With Arrhythmogenic Right Ventricular Cardiomyopathy Using the Clinical Genome Resource Framework. \| journal=Circ Genom Precis Med \| year= 2021 \| volume= 14 \| issue= 3 \| pages= e003273 \| pmid=33831308 \| doi=10.1161/CIRCGEN.120.003273 \| pmc=8205996 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33831308 }} </ref> <ref name="pmid32429735">{{cite journal\| author=Lahrouchi N, Tadros R, Crotti L, Mizusawa Y, Postema PG, Beekman L \| display-authors=etal\| title=Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 4 \| pages= 324-338 \| pmid=32429735 \| doi=10.1161/CIRCULATIONAHA.120.045956 \| pmc=7382531 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32429735 }} </ref> <ref name="pmid33164571">{{cite journal\| author=Wijeyeratne YD, Tanck MW, Mizusawa Y, Batchvarov V, Barc J, Crotti L \| display-authors=etal\| title=SCN5A Mutation Type and a Genetic Risk Score Associate Variably With Brugada Syndrome Phenotype in SCN5A Families. \| journal=Circ Genom Precis Med \| year= 2020 \| volume= 13 \| issue= 6 \| pages= e002911 \| pmid=33164571 \| doi=10.1161/CIRCGEN.120.002911 \| pmc=7748043 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33164571 }} </ref> <ref name="pmid33495597">{{cite journal\| author=Harper AR, Goel A, Grace C, Thomson KL, Petersen SE, Xu X \| display-authors=etal\| title=Common genetic variants and modifiable risk factors underpin hypertrophic cardiomyopathy susceptibility and expressivity. \| journal=Nat Genet \| year= 2021 \| volume= 53 \| issue= 2 \| pages= 135-142 \| pmid=33495597 \| doi=10.1038/s41588-020-00764-0 \| pmc=8240954 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495597 }} </ref> <ref name="pmid33495596">{{cite journal\| author=Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R \| display-authors=etal\| title=Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect. \| journal=Nat Genet \| year= 2021 \| volume= 53 \| issue= 2 \| pages= 128-134 \| pmid=33495596 \| doi=10.1038/s41588-020-00762-2 \| pmc=7611259 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495596 }} </ref> <ref name="pmid31504448">{{cite journal\| author=Tadros R, Tan HL, ESCAPE-NET Investigators. El Mathari S, Kors JA, Postema PG \| display-authors=etal\| title=Predicting cardiac electrical response to sodium-channel blockade and Brugada syndrome using polygenic risk scores. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 37 \| pages= 3097-3107 \| pmid=31504448 \| doi=10.1093/eurheartj/ehz435 \| pmc=6769824 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31504448 }} </ref>.		* Genetic testing of young adults may be useful for diagnosis and treatment of cardiomyopathies and primary arrhythmia syndromes.Genetic testing of first-degree family members may help identify asymptomatically affected relatives. The reported diagnostic yield of genetic testing among individuals with sudden arrhythmic death syndrome(normal heart at autopsy with no cause of death identified) is 13% to 34%, whereas the yield of genetic testing of survivors of sudden cardiac arrest resuscitated from idiopathic ventricular arrhythmias is 2% to 22%.It is used to identify [[genetic]] composition of an individual and determine whether genetic variation modifications are present leading to [[Brugada syndrome]], [[long QT syndrome]] ([[LQTS]]), [[hypertrophic cardiomyopathy]] ([[HCM]]), and [[dilated cardiomyopathy]] ([[DCM]]) <ref name="pmid33831308">{{cite journal\| author=James CA, Jongbloed JDH, Hershberger RE, Morales A, Judge DP, Syrris P \| display-authors=etal\| title=International Evidence Based Reappraisal of Genes Associated With Arrhythmogenic Right Ventricular Cardiomyopathy Using the Clinical Genome Resource Framework. \| journal=Circ Genom Precis Med \| year= 2021 \| volume= 14 \| issue= 3 \| pages= e003273 \| pmid=33831308 \| doi=10.1161/CIRCGEN.120.003273 \| pmc=8205996 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33831308 }} </ref> <ref name="pmid32429735">{{cite journal\| author=Lahrouchi N, Tadros R, Crotti L, Mizusawa Y, Postema PG, Beekman L \| display-authors=etal\| title=Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 4 \| pages= 324-338 \| pmid=32429735 \| doi=10.1161/CIRCULATIONAHA.120.045956 \| pmc=7382531 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32429735 }} </ref> <ref name="pmid33164571">{{cite journal\| author=Wijeyeratne YD, Tanck MW, Mizusawa Y, Batchvarov V, Barc J, Crotti L \| display-authors=etal\| title=SCN5A Mutation Type and a Genetic Risk Score Associate Variably With Brugada Syndrome Phenotype in SCN5A Families. \| journal=Circ Genom Precis Med \| year= 2020 \| volume= 13 \| issue= 6 \| pages= e002911 \| pmid=33164571 \| doi=10.1161/CIRCGEN.120.002911 \| pmc=7748043 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33164571 }} </ref> <ref name="pmid33495597">{{cite journal\| author=Harper AR, Goel A, Grace C, Thomson KL, Petersen SE, Xu X \| display-authors=etal\| title=Common genetic variants and modifiable risk factors underpin hypertrophic cardiomyopathy susceptibility and expressivity. \| journal=Nat Genet \| year= 2021 \| volume= 53 \| issue= 2 \| pages= 135-142 \| pmid=33495597 \| doi=10.1038/s41588-020-00764-0 \| pmc=8240954 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495597 }} </ref> <ref name="pmid33495596">{{cite journal\| author=Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R \| display-authors=etal\| title=Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect. \| journal=Nat Genet \| year= 2021 \| volume= 53 \| issue= 2 \| pages= 128-134 \| pmid=33495596 \| doi=10.1038/s41588-020-00762-2 \| pmc=7611259 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33495596 }} </ref> <ref name="pmid31504448">{{cite journal\| author=Tadros R, Tan HL, ESCAPE-NET Investigators. El Mathari S, Kors JA, Postema PG \| display-authors=etal\| title=Predicting cardiac electrical response to sodium-channel blockade and Brugada syndrome using polygenic risk scores. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 37 \| pages= 3097-3107 \| pmid=31504448 \| doi=10.1093/eurheartj/ehz435 \| pmc=6769824 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31504448 }} </ref>.

Sudden cardiac death post arrest care and prevention

2026-03-29T00:25:26Z

Overview

← Older revision		Revision as of 00:25, 29 March 2026
(One intermediate revision by the same user not shown)
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	__NOTOC__		__NOTOC__
	{{Sudden cardiac death}}		{{Sudden cardiac death}}
	{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}}		{{CMG}} {{AE}} {{Sara.Zand}} {{EdzelCo}} {{Nehal}}

	See also [[Post cardiac arrest syndrome care pathway]]		See also [[Post cardiac arrest syndrome care pathway]]
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	==Overview==		==Overview==
	*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.		*Effective measures for the [[primary prevention]] of [[sudden cardiac death]] ([[SCD]]) in individuals who are at risk of [[SCD]] but have not yet experienced an aborted [[cardiac arrest]] or [[life-threatening arrhythmias]] include [[implantable cardioverter defibrillator]] ([[ICD]]) based on the guideline.
	*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].		*[[Secondary prevention]] strategy following aborted sudden cardiac death include [[revascularization]] in patients with [[ischemic heart disease]] and [[ICD]] implantation in patients with reduced [[left ventricular ejection fraction]] who had an experience of lethal [[arrhythmia]].
	*The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].		*The optimal approach to prevention of [[SCD]] following [[ST-elevation MI]] ([[STEMI]]) has been evaluated in multiple randomized trials. In general, [[post-STEMI]] [[patients ]]should be treated with evidence-based therapies that have been associated with a reduction in [[SCD]] including [[beta-blockers]], [[ACE-inhibitors]] (or [[ARB]]s in [[patients]] who are [[ACEI]] intolerant) and [[statins]].
	*In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].		*In [[patients]] who have symptomatic [[congestive heart failure]] ([[CHF]]), an [[aldosterone antagonist]] may be a reasonable additional therapy. Despite the intuitive benefits of [[antiarrhythmic]], [[amiodarone]] and [[sotalol]] have not been shown to reduce all-cause [[mortality]] following [[STEMI]], although [[amiodarone]] may be useful in reducing the frequency of [[shocks]] in [[patients]] with [[ICD]]s who have unacceptably high rates of [[shock]].
	*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.		*In general terms, [[ICD placement]] is indicated in those [[patients]] with a reduced [[left ventricular]] [[ejection fraction]] at 40 days [[post-MI]] and/or 3 months following [[revascularization]] ([[PCI]] or [[CABG]]) for [[STEMI]] given the survival benefits in this population.
			*In absence of noncardiac or reversible causes, an implantable cardioverter-defibrillator (ICD) is recommended because of the high risk of recurrent lethal ventricular arrhythmias. Adjunctive therapy (eg, amiodarone, catheter ablation) and lifestyle modifications for certain genetic arrhythmia syndromes may reduce ventricular arrhythmia recurrence after ICD placement.

	== Prevention ==		== Prevention ==

Sudden cardiac death epidemiology and demographics

2026-03-29T00:15:04Z

Epidemiology and demographics

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	* Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100000 person-years worldwide.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. ''JAMA.'' 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>		* Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100000 person-years worldwide.<ref name=":0">Tseng ZH, Nakasuka K. Out-of-Hospital Cardiac Arrest in Apparently Healthy, Young Adults. ''JAMA.'' 2025;333(11):981–996. doi:10.1001/jama.2024.27916</ref>
	* .Of an estimated 350,000 to 450,000 total annual out-of-hospital cardiac arrests in the US,approximately 10% survive.<ref>Tsao CW, Aday AW, Almarzooq ZI, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93-e621. doi:10.1161/CIR.0000000000001123</ref>		* .Of an estimated 350,000 to 450,000 total annual out-of-hospital cardiac arrests in the US,approximately 10% survive.<ref>Tsao CW, Aday AW, Almarzooq ZI, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93-e621. doi:10.1161/CIR.0000000000001123</ref>
	* ~~Among~~ young adults who ~~have had~~ cardiac arrest outside of a hospital~~, 60%~~ die before reaching hospital, 40% ~~survive to hospitalization, and 9~~ to 16% survive ~~to hosiptal discharge. Approximately~~ 90% ~~of the arrest survivors~~ have ~~a good~~ neurological ~~status.~~<ref name=":0" />		* Approximately 60% of young adults aged 18 through 39 years who experience cardiac arrest outside a hospital die before reaching the hospital. Overall, 9% to 16%survive, of whom 90% have favorable neurological outcomes<ref name=":0" />
	* In some middle-aged males, sports is related to [[SCD]] which occurs more frequently in a recreational setting than a competition <ref name="pmid21788587">{{cite journal\| author=Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H \| display-authors=etal\| title=Sports-related sudden death in the general population. \| journal=Circulation \| year= 2011 \| volume= 124 \| issue= 6 \| pages= 672-81 \| pmid=21788587 \| doi=10.1161/CIRCULATIONAHA.110.008979 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21788587 }} </ref> <ref name="pmid30813818">{{cite journal\| author=Heidbuchel H, Willems R, Jordaens L, Olshansky B, Carre F, Lozano IF \| display-authors=etal\| title=Intensive recreational athletes in the prospective multinational ICD Sports Safety Registry: Results from the European cohort. \| journal=Eur J Prev Cardiol \| year= 2019 \| volume= 26 \| issue= 7 \| pages= 764-775 \| pmid=30813818 \| doi=10.1177/2047487319834852 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30813818 }} </ref>. In these instances, [[coronary artery disease]] ([[CAD]]) is the most common cause <ref name="pmid24861446">{{cite journal\| author=Risgaard B, Winkel BG, Jabbari R, Glinge C, Ingemann-Hansen O, Thomsen JL \| display-authors=etal\| title=Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. \| journal=Heart Rhythm \| year= 2014 \| volume= 11 \| issue= 10 \| pages= 1673-81 \| pmid=24861446 \| doi=10.1016/j.hrthm.2014.05.026 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24861446 }} </ref> <ref name="pmid23942684">{{cite journal\| author=Marijon E, Bougouin W, Périer MC, Celermajer DS, Jouven X\| title=Incidence of sports-related sudden death in France by specific sports and sex. \| journal=JAMA \| year= 2013 \| volume= 310 \| issue= 6 \| pages= 642-3 \| pmid=23942684 \| doi=10.1001/jama.2013.8711 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23942684 }} </ref><ref name="pmid25847988">{{cite journal\| author=Marijon E, Uy-Evanado A, Reinier K, Teodorescu C, Narayanan K, Jouven X \| display-authors=etal\| title=Sudden cardiac arrest during sports activity in middle age. \| journal=Circulation \| year= 2015 \| volume= 131 \| issue= 16 \| pages= 1384-91 \| pmid=25847988 \| doi=10.1161/CIRCULATIONAHA.114.011988 \| pmc=4406826 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25847988 }} </ref>.		* In some middle-aged males, sports is related to [[SCD]] which occurs more frequently in a recreational setting than a competition <ref name="pmid21788587">{{cite journal\| author=Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier MC, Mustafic H \| display-authors=etal\| title=Sports-related sudden death in the general population. \| journal=Circulation \| year= 2011 \| volume= 124 \| issue= 6 \| pages= 672-81 \| pmid=21788587 \| doi=10.1161/CIRCULATIONAHA.110.008979 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21788587 }} </ref> <ref name="pmid30813818">{{cite journal\| author=Heidbuchel H, Willems R, Jordaens L, Olshansky B, Carre F, Lozano IF \| display-authors=etal\| title=Intensive recreational athletes in the prospective multinational ICD Sports Safety Registry: Results from the European cohort. \| journal=Eur J Prev Cardiol \| year= 2019 \| volume= 26 \| issue= 7 \| pages= 764-775 \| pmid=30813818 \| doi=10.1177/2047487319834852 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30813818 }} </ref>. In these instances, [[coronary artery disease]] ([[CAD]]) is the most common cause <ref name="pmid24861446">{{cite journal\| author=Risgaard B, Winkel BG, Jabbari R, Glinge C, Ingemann-Hansen O, Thomsen JL \| display-authors=etal\| title=Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. \| journal=Heart Rhythm \| year= 2014 \| volume= 11 \| issue= 10 \| pages= 1673-81 \| pmid=24861446 \| doi=10.1016/j.hrthm.2014.05.026 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24861446 }} </ref> <ref name="pmid23942684">{{cite journal\| author=Marijon E, Bougouin W, Périer MC, Celermajer DS, Jouven X\| title=Incidence of sports-related sudden death in France by specific sports and sex. \| journal=JAMA \| year= 2013 \| volume= 310 \| issue= 6 \| pages= 642-3 \| pmid=23942684 \| doi=10.1001/jama.2013.8711 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23942684 }} </ref><ref name="pmid25847988">{{cite journal\| author=Marijon E, Uy-Evanado A, Reinier K, Teodorescu C, Narayanan K, Jouven X \| display-authors=etal\| title=Sudden cardiac arrest during sports activity in middle age. \| journal=Circulation \| year= 2015 \| volume= 131 \| issue= 16 \| pages= 1384-91 \| pmid=25847988 \| doi=10.1161/CIRCULATIONAHA.114.011988 \| pmc=4406826 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25847988 }} </ref>.

Sudden cardiac versus non-cardiac death

2026-03-29T00:02:52Z

Overview

← Older revision		Revision as of 00:02, 29 March 2026
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	==Overview==		==Overview==
	*[[Sudden cardiac death]] ([[SCD]]) is a natural, rapid, unexpected [[death]] secondary to [[cardiac]] causes within an hour of [[symptom onset]] in witnessed scenarios, and within a day in unwitnessed cases <ref name="pmid36844932">{{cite journal\| author=Calvo Cuervo D\| title=Comment on the ESC Guidelines 2022 for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. \| journal=Eur Cardiol \| year= 2023 \| volume= 18 \| issue= \| pages= e01 \| pmid=36844932 \| doi=10.15420/ecr.2022.48 \| pmc=9947934 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36844932 }} </ref>.		*[[Sudden cardiac death]] ([[SCD]]) is a natural, rapid, unexpected [[death]] secondary to [[cardiac]] causes within an hour of [[symptom onset]] in witnessed scenarios, and within a day in unwitnessed cases <ref name="pmid36844932">{{cite journal\| author=Calvo Cuervo D\| title=Comment on the ESC Guidelines 2022 for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. \| journal=Eur Cardiol \| year= 2023 \| volume= 18 \| issue= \| pages= e01 \| pmid=36844932 \| doi=10.15420/ecr.2022.48 \| pmc=9947934 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=36844932 }} </ref>.
	*The case definitions of sudden cardiac death in clinical registries or epidemiological research vary based on the use of death certificates,<ref>GillumRF.Sudden coronary death in the United States: 1980-1985. Circulation. 1989;79(4):756-765. doi:10.1161/01.CIR.79.4.756</ref> <ref>Escobedo LG, Zack MM. Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033</ref> <ref>Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States,1989 to 1998. Circulation. 2001;104(18):2158-2163. doi:10.1161/hc4301.098254</ref> <ref name=":0">Kitamura T, Iwami T, Nichol G, et al; Utstein OsakaProject. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010;31(11):1365-1372. doi:10.1093/eurheartj/ehq059</ref> reviews of EMS<ref name=":0" /> or hospital ~~records6~~,9-12 or whether the cases met the criteria of epidemiological definitions (eg, World Health Organization),13 society definitions (eg, Cardiac Arrest Registry to EnhanceSurvival [CARES]),~~3,4~~ outcomes of clinical trials,14-17 or the definition required in pathology-based studies.18-27 Because most individuals who died from sudden cardiac death do not have autopsies to confirm the underlying cause, sudden cardiac death is typically presumed to be of cardiac etiology.28		*The case definitions of sudden cardiac death in clinical registries or epidemiological research vary based on the use of death certificates,<ref>GillumRF.Sudden coronary death in the United States: 1980-1985. Circulation. 1989;79(4):756-765. doi:10.1161/01.CIR.79.4.756</ref> <ref>Escobedo LG, Zack MM. Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033</ref> <ref>Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States,1989 to 1998. Circulation. 2001;104(18):2158-2163. doi:10.1161/hc4301.098254</ref> <ref name=":0">Kitamura T, Iwami T, Nichol G, et al; Utstein OsakaProject. Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age. Eur Heart J. 2010;31(11):1365-1372. doi:10.1093/eurheartj/ehq059</ref> reviews of EMS<ref name=":0" /> or hospital records<ref>Escobedo LG,Zack MM.Comparison of sudden and nonsudden coronary deaths in the United States. Circulation. 1996;93(11):2033-2036. doi:10. 1161/01.CIR.93.11.2033</ref>,<ref>Nichol G,Rumsfeld J,Eigel B,et al; American Heart Association Emergency Cardiovascular Care Committee;American Heart Association Council on Cardiopulmonary, Perioperative, and Critical Care; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; Quality of Care and Outcomes Research Interdisciplinary Working Group.Essential features of designating out-of-hospital cardiac arrest as a reportable event: a scientific statement from the American Heart Association Emergency Cardiovascular Care Committee;Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes ResearchInterdisciplinary Working Group. Circulation. 2008;117(17):2299-2308. doi:10.1161/ CIRCULATIONAHA.107.189472</ref> <ref>Bonny A,Tibazarwa K,Mbouh S,et al; Pan African Society of Cardiology (PASCAR) Task Force on Sudden Cardiac Death.Epidemiology of sudden cardiac death in Cameroon:the first population-based cohort survey in sub-Saharan Africa. Int J Epidemiol. 2017;46(4):1230-1238. doi:10.1093/ije/dyx043</ref><ref>Meyer L,Stubbs B,Fahrenbruch C,et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0to35 years of age: a30-year review. Circulation. 2012;126(11):1363-1372. doi:10.1161/CIRCULATIONAHA.111.076810</ref><ref>Zhang J,Zhou X,Xing Q,et al.Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomous region in Northwest China. BMC Public Health. 2019;19(1):116. doi:10. 1186/s12889-019-6435-8</ref> or whether the cases met the criteria of epidemiological definitions (eg, World Health Organization),<ref>Sudden cardiac death.Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1985;726:5-25.</ref>society definitions (eg, Cardiac Arrest Registry to EnhanceSurvival [CARES]),<ref name=":1" /> outcomes of clinical trials,<ref>Chatterjee NA,Moorthy MV,Pester J,et al; PRE-DETERMINE Study Group.Sudden death in patients with coronary heart disease without severe systolic dysfunction. JAMA Cardiol. 2018;3 (7):591-600. doi:10.1001/jamacardio.2018.1049</ref><ref>Olgin JE, Pletcher MJ, Vittinghoff E, et al; VEST Investigators. Wearable cardioverter-defibrillator after myocardial infarction. N Engl J Med. 2018;379 (13):1205-1215. doi:10.1056/NEJMoa1800781</ref> or the definition required in pathology-based studies.<ref>Tseng ZH,Olgin JE,Vittinghoff E, et al. Prospective countywide surveillance and autopsy characterization of sudden cardiac death: POST SCD study.Circulation. 2018;137(25):2689-2700. doi:10.1161/CIRCULATIONAHA.117.033427</ref><ref>Wu Q, Zhang L, Zheng J,et al.Forensic pathological study of 1656 cases of sudden cardiac death in southern China. Medicine (Baltimore). 2016;95(5):e2707. doi:10.1097/MD.0000000000002707</ref><ref>Bagnall RD,Weintraub RG,Ingles J,et al. A prospective study of sudden cardiac death among children and young adults. NEnglJMed.2016;374 (25):2441-2452. doi:10.1056/NEJMoa1510687</ref> Because most individuals who died from sudden cardiac death do not have autopsies to confirm the underlying cause, sudden cardiac death is typically presumed to be of cardiac etiology.<ref>Marijon E,Narayanan K,Smith K,et al.The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet. 2023;402(10405):883-936. doi:10.1016/S0140-6736(23)00875-9</ref>
	* [[Sudden cardiac arrest]] ([[SCA]]) is the unexpected cessation of pumping [[blood]] into vital [[organs]] due to electrical disturbance in the pathway of [[sinoatrial node]] ([[SA node]]), [[atrioventricular node]] ([[AV node]]), [[His Purkinje fibers]] or [[cardiac]] pumping failure due to [[cardiogenic shock]], massive [[pulmonary thromboembolism]],[[fulminant myocarditis]], and [[ruptured left ventricular free wall]].		* [[Sudden cardiac arrest]] ([[SCA]]) is the unexpected cessation of pumping [[blood]] into vital [[organs]] due to electrical disturbance in the pathway of [[sinoatrial node]] ([[SA node]]), [[atrioventricular node]] ([[AV node]]), [[His Purkinje fibers]] or [[cardiac]] pumping failure due to [[cardiogenic shock]], massive [[pulmonary thromboembolism]],[[fulminant myocarditis]], and [[ruptured left ventricular free wall]].
	* Out-of-hospital cardiac arrests are “events that occur out of the hospital in which an emergency medical services (EMS) rescuer detects no signs of circulation or mechanical cardiac activity.”<ref>McNally B, Stokes A, Crouch A, Kellermann AL, Group CS; CARESSurveillanceGroup. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683.e2.doi:10.1016/j. annemergmed.2009.03.018</ref><ref>McNally B,Robb R,Mehta M,etal. Out-of-hospital cardiac arrest surveillance—Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005–December31, 2010. MMWRSurveillSumm.2011;60(8):1-19.</ref>		* Out-of-hospital cardiac arrests are “events that occur out of the hospital in which an emergency medical services (EMS) rescuer detects no signs of circulation or mechanical cardiac activity.”<ref name=":1">McNally B, Stokes A, Crouch A, Kellermann AL, Group CS; CARESSurveillanceGroup. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683.e2.doi:10.1016/j. annemergmed.2009.03.018</ref><ref>McNally B,Robb R,Mehta M,etal. Out-of-hospital cardiac arrest surveillance—Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005–December31, 2010. MMWRSurveillSumm.2011;60(8):1-19.</ref>
	*Without any intervention for immediate restoration of the [[circulation]], [[biologic death]] will happen minutes to weeks after [[cardiac arrest]]. [[Sudden cardiac death]] in the United States ranges from 300,000 to 400,000 which is 50% of all causes of deaths. <ref name="pmid21513133">{{cite journal\| author=Haissaguerre M, Hocini M, Sacher F, Shah A\| title=[Sudden cardiac death, a major scientific challenge]. \| journal=Bull Acad Natl Med \| year= 2010 \| volume= 194 \| issue= 6 \| pages= 983-93; discussion 993-5 \| pmid=21513133 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21513133 }} </ref> In-hospital [[cardiac arrest]] happens in 290,000 adults every year in the United States. The most common cause of [[sudden cardiac death]] is [[coronary artery disease]] and [[atherosclerosis]]. The presence of underlying disorders such as [[malignancy]] or [[liver disease]] at the time of [[ cardiac arrest]] makes the condition worse. Patients with [[acute myocardial infarction]] and [[in-hospital cardiac arrest]] with shockable [[rhythm]] have a better prognosis. Post [[cardiopulmonary resuscitation]] state management should be focused on [[neurologic]] [[complications]], [[hemodynamic]] stability, and [[respiratory]] support.		*Without any intervention for immediate restoration of the [[circulation]], [[biologic death]] will happen minutes to weeks after [[cardiac arrest]]. [[Sudden cardiac death]] in the United States ranges from 300,000 to 400,000 which is 50% of all causes of deaths. <ref name="pmid21513133">{{cite journal\| author=Haissaguerre M, Hocini M, Sacher F, Shah A\| title=[Sudden cardiac death, a major scientific challenge]. \| journal=Bull Acad Natl Med \| year= 2010 \| volume= 194 \| issue= 6 \| pages= 983-93; discussion 993-5 \| pmid=21513133 \| doi= \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21513133 }} </ref> In-hospital [[cardiac arrest]] happens in 290,000 adults every year in the United States. The most common cause of [[sudden cardiac death]] is [[coronary artery disease]] and [[atherosclerosis]]. The presence of underlying disorders such as [[malignancy]] or [[liver disease]] at the time of [[ cardiac arrest]] makes the condition worse. Patients with [[acute myocardial infarction]] and [[in-hospital cardiac arrest]] with shockable [[rhythm]] have a better prognosis. Post [[cardiopulmonary resuscitation]] state management should be focused on [[neurologic]] [[complications]], [[hemodynamic]] stability, and [[respiratory]] support.

Industrial and organizational psychology

2026-03-28T17:39:31Z

Workforce well-being

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	Workforce wellbeing has been described as a combination states, "job satisfaction, work engagement, and lower burnout"<ref name="BroeckVansteenkisteWitte2010">{{cite journal \| last1 = Broeck \| first1 = Anja \| last2 = Vansteenkiste \| first2 = Maarten \| last3 = Witte \| first3 = Hans \| last4 = Soenens \| first4 = Bart \| last5 = Lens \| first5 = Willy \| title = Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work-related Basic Need Satisfaction scale \| journal = Journal of Occupational and Organizational Psychology \| date = December 2010 \| volume = 83 \| issue = 4 \| pages = 981–1002 \| issn = 0963-1798 \| doi = 10.1348/096317909X481382 \| pmid = \| url = }}</ref>.		Workforce wellbeing has been described as a combination states, "job satisfaction, work engagement, and lower burnout"<ref name="BroeckVansteenkisteWitte2010">{{cite journal \| last1 = Broeck \| first1 = Anja \| last2 = Vansteenkiste \| first2 = Maarten \| last3 = Witte \| first3 = Hans \| last4 = Soenens \| first4 = Bart \| last5 = Lens \| first5 = Willy \| title = Capturing autonomy, competence, and relatedness at work: Construction and initial validation of the Work-related Basic Need Satisfaction scale \| journal = Journal of Occupational and Organizational Psychology \| date = December 2010 \| volume = 83 \| issue = 4 \| pages = 981–1002 \| issn = 0963-1798 \| doi = 10.1348/096317909X481382 \| pmid = \| url = }}</ref>.

			* [[Well-being\|Well-being]]
	* [[Flourishing(psychology)\|Flourishing]]		* [[Flourishing(psychology)\|Flourishing]]
	* [[Thriving (psychology)\|Thriving]]		* [[Thriving (psychology)\|Thriving]]
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	Outcomes of these states are discussed in the separate "Outcomes" section below this.		Outcomes of these states are discussed in the separate "Outcomes" section below this.

			===Workforce well-being ===
			The National Academies in 2019 and 2024 defined Professional well-being is a “function of being satisfied with one’s job, finding meaning in work, feeling engaged at work, having a high-quality working life, and finding professional fulfillment in work."<ref name = "NA2019">{{cite book \| vauthors=Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being, National Academy of Medicine, National Academies of Sciences, Engineering, and Medicine \| date=2 December 2019 \| title=Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being \| publisher=National Academies Press \| url=https://www.nationalacademies.org/publications/25521 \| doi=10.17226/25521 \| isbn=978-0-309-49547-9}}</ref><ref name="NA2024">{{cite book \| vauthors=Action Collaborative on Clinician Well-Being and Resilience, National Academy of Medicine \| veditors=((Dzau, V. J.)), ((Kirch, D.)), ((Murthy, V.)), ((Nasca, T.)) \| date=28 February 2024 \| title=National Plan for Health Workforce Well-Being \| publisher=National Academies Press \| url=https://www.nationalacademies.org/publications/26744 \| doi=10.17226/26744 \| isbn=978-0-309-69467-4}}
			</ref>

			Earlier, in 1999, Danna summarized literature to date but did not synthesize a final definition<ref name="i345">{{cite journal \| last1=Danna \| first1=Karen \| last2=Griffin \| first2=Ricky W. \| title=Health and Well-Being in the Workplace: A Review and Synthesis of the Literature \| journal=Journal of Management \| volume=25 \| issue=3 \| date=1999 \| issn=0149-2063 \| doi=10.1177/014920639902500305 \| pages=357–384 \| url=https://journals.sagepub.com/doi/10.1177/014920639902500305 \| access-date=2026-03-28}}</ref>

	===Flourishing===		===Flourishing===