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(/* 2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death {{cite journal| author=van der Werf C, Hofman N, Tan HL, van Dessel PF, Alders M, van der Wal AC | display-authors=etal| title=Diagnostic yield in sudden unexplained death and aborted cardiac arrest in the young: the experience of a tertiary referral center in The Netherlands. | journal=Heart Rhythm | year= 2010 | volume= 7 | issue= 10 | pages= 1383-9 | pmid=20646679 |...)
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(/* 2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death {{cite journal| author=van der Werf C, Hofman N, Tan HL, van Dessel PF, Alders M, van der Wal AC | display-authors=etal| title=Diagnostic yield in sudden unexplained death and aborted cardiac arrest in the young: the experience of a tertiary referral center in The Netherlands. | journal=Heart Rhythm | year= 2010 | volume= 7 | issue= 10 | pages= 1383-9 | pmid=20646679 |...)
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* Baseline [[familial evaluation]] of [[sudden arrhythmic death syndrome]] ([[SADS]] decedents is recommended to include taking a [[medical history]] and performing [[physical examination]], standard and high [[precordial lead ECG]], [[echocardiography]], and [[exercise testing]].  
* Baseline [[familial evaluation]] of [[sudden arrhythmic death syndrome]] ([[SADS]]) decedents is recommended to include taking a [[medical history]] and performing [[physical examination]], standard and high [[precordial lead ECG]], [[echocardiography]], and [[exercise testing]].  
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Revision as of 22:18, 19 July 2023

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] José Eduardo Riceto Loyola Junior, M.D.[3] Edzel Lorraine Co, DMD, MD[4]

Overview

An electrocardiogram (ECG) may be helpful in the diagnosis of Sudden cardiac death. Findings on ECG associated with sudden cardiac arrest (SCA) include Sinus tachycardia (39%), abnormal T-wave inversions (30%), prolonged QT interval (26%), left/right atrial abnormality (22%), left ventricular hypertrophy (17%), abnormal frontal QRS axis (17%), delayed QRS-transition zone in precordial leads (13%), pathological Q waves (13%), intraventricular conduction delays (9%), multiple premature ventricular contractions (9%), normal ECG (9%).

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:[1]

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.[2]


2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death [3] [4] [5] [6] [7]

Class I (Level of Evidence: B)

2017AHA/ACC/HRS Guideline for management of sudden cardiac arrest and ventricular arrhythmia

[8]

Class I (Level of Evidence: B)


Class of recommendation Level of evidence Recommendation for ECG and exercise tredmile test
1 B In patients with wide complex tachycardia and hemodynamically stable, 12 leads ECG should be obtained
1 B Exercise stress test should be obtained in patients suspected arrhythmia-related exercise such as ischemic heart disease or cathecolaminergic polymorphic ventricular tachycardia
1 B In patients with documented ventricular arrhythmia, 12 leads ECG should be obtained during sinus rhythm for evaluation of underlying heart disease

References

  1. Jayaraman, Reshmy; Reinier, Kyndaron; Nair, Sandeep; Aro, Aapo L.; Uy-Evanado, Audrey; Rusinaru, Carmen; Stecker, Eric C.; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S. (2018). "Risk Factors of Sudden Cardiac Death in the Young". Circulation. 137 (15): 1561–1570. doi:10.1161/CIRCULATIONAHA.117.031262. ISSN 0009-7322.
  2. Tsushima T, Patel TR, Sahadevan J (2021). "Unusual Cause of Cardiac Arrest". JAMA Intern Med. 181 (4): 542–543. doi:10.1001/jamainternmed.2020.8370. PMID 33464284 Check |pmid= value (help).
  3. van der Werf C, Hofman N, Tan HL, van Dessel PF, Alders M, van der Wal AC; et al. (2010). "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. 7 (10): 1383–9. doi:10.1016/j.hrthm.2010.05.036. PMID 20646679.
  4. Behr E, Wood DA, Wright M, Syrris P, Sheppard MN, Casey A; et al. (2003). "Cardiological assessment of first-degree relatives in sudden arrhythmic death syndrome". Lancet. 362 (9394): 1457–9. doi:10.1016/s0140-6736(03)14692-2. PMID 14602442.
  5. Tan HL, Hofman N, van Langen IM, van der Wal AC, Wilde AA (2005). "Sudden unexplained death: heritability and diagnostic yield of cardiological and genetic examination in surviving relatives". Circulation. 112 (2): 207–13. doi:10.1161/CIRCULATIONAHA.104.522581. PMID 15998675.
  6. Behr ER, Dalageorgou C, Christiansen M, Syrris P, Hughes S, Tome Esteban MT; et al. (2008). "Sudden arrhythmic death syndrome: familial evaluation identifies inheritable heart disease in the majority of families". Eur Heart J. 29 (13): 1670–80. doi:10.1093/eurheartj/ehn219. PMID 18508782.
  7. Papadakis M, Papatheodorou E, Mellor G, Raju H, Bastiaenen R, Wijeyeratne Y; et al. (2018). "The Diagnostic Yield of Brugada Syndrome After Sudden Death With Normal Autopsy". J Am Coll Cardiol. 71 (11): 1204–1214. doi:10.1016/j.jacc.2018.01.031. PMID 29544603.
  8. Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". Circulation. 138 (13). doi:10.1161/CIR.0000000000000549. ISSN 0009-7322.

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