wikidoc - Recent changes [en]

Sudden cardiac death risk factors

2026-04-06T16:54:56Z

Risk Factors

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 :*[[Early repolarization]] patten in early phase of [[MI]]<ref name="NaruseTada2012">{{cite journal|last1=Naruse|first1=Yoshihisa|last2=Tada|first2=Hiroshi|last3=Harimura|first3=Yoshie|last4=Hayashi|first4=Mayu|last5=Noguchi|first5=Yuichi|last6=Sato|first6=Akira|last7=Yoshida|first7=Kentaro|last8=Sekiguchi|first8=Yukio|last9=Aonuma|first9=Kazutaka|title=Early Repolarization Is an Independent Predictor of Occurrences of Ventricular Fibrillation in the Very Early Phase of Acute Myocardial Infarction|journal=Circulation: Arrhythmia and Electrophysiology|volume=5|issue=3|year=2012|pages=506–513|issn=1941-3149|doi=10.1161/CIRCEP.111.966952}}</ref>
 :*Family history of premature death (sudden and unexpected) before age 50 attributed to [[heart]] disease in > 1 relative, presence of [[heart]] disease in close relative less than age 50, presence of ion [[channelopathies]] in family members
 ==References==

Sudden cardiac death screening

2026-04-06T14:43:45Z

Screening

← Older revision		Revision as of 14:43, 6 April 2026
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	==Screening==		==Screening==
	*~~[[Screening]]~~ in the ~~first relative~~ of [[patients]] with [[sudden cardiac arrest~~]] should be done if there is concern about inherited causes~~ of [[cardiac arrest]].		*If the phenotype in a patient resuscitated after sudden cardiac arrest is established, a recent expert consensus statement<ref name=":0">Stiles MK, Wilde AAM, Abrams DJ, et al. 2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families. Heart Rhythm. 2021;18(1):e1-e50. doi:10.1016/j.hrthm.2020.10.010</ref> recommends genetic testing focused on potential candidate genes and clinical evaluation of family members to identify relatives who have or are at risk of developing a clinical condition.
			*If the cause of sudden cardiac arrest is not determined, first-degree relatives may undergo clinical evaluation, including ECG, cardiac imaging, ambulatory monitoring, and provocative testing.
			*Psychological evaluation and treatment of grief and post traumatic stress in survivors and their immediate family members by trained mental health professionals is recommended.<ref name=":0" />
	*Several [[SCD]] [[risk calculators]] are available for all age groups <ref name="pmid31155932">{{cite journal\| author=Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK \| display-authors=etal\| title=Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. \| journal=Circulation \| year= 2019 \| volume= 140 \| issue= 4 \| pages= 293-302 \| pmid=31155932 \| doi=10.1161/CIRCULATIONAHA.118.039410 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31155932 }} </ref> <ref name="pmid30915475">{{cite journal\| author=Cadrin-Tourigny J, Bosman LP, Nozza A, Wang W, Tadros R, Bhonsale A \| display-authors=etal\| title=A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 23 \| pages= 1850-1858 \| pmid=30915475 \| doi=10.1093/eurheartj/ehz103 \| pmc=6568197 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30915475 }} </ref> <ref name="pmid32418493">{{cite journal\| author=Miron A, Lafreniere-Roula M, Steve Fan CP, Armstrong KR, Dragulescu A, Papaz T \| display-authors=etal\| title=A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 3 \| pages= 217-229 \| pmid=32418493 \| doi=10.1161/CIRCULATIONAHA.120.047235 \| pmc=7365676 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32418493 }} </ref> <ref name="pmid31411652">{{cite journal\| author=Norrish G, Ding T, Field E, Ziólkowska L, Olivotto I, Limongelli G \| display-authors=etal\| title=Development of a Novel Risk Prediction Model for Sudden Cardiac Death in Childhood Hypertrophic Cardiomyopathy (HCM Risk-Kids). \| journal=JAMA Cardiol \| year= 2019 \| volume= 4 \| issue= 9 \| pages= 918-927 \| pmid=31411652 \| doi=10.1001/jamacardio.2019.2861 \| pmc=6694401 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31411652 }} </ref> <ref name="pmid24126876">{{cite journal\| author=O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C \| display-authors=etal\| title=A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). \| journal=Eur Heart J \| year= 2014 \| volume= 35 \| issue= 30 \| pages= 2010-20 \| pmid=24126876 \| doi=10.1093/eurheartj/eht439 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24126876 }} </ref>		*Several [[SCD]] [[risk calculators]] are available for all age groups <ref name="pmid31155932">{{cite journal\| author=Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK \| display-authors=etal\| title=Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. \| journal=Circulation \| year= 2019 \| volume= 140 \| issue= 4 \| pages= 293-302 \| pmid=31155932 \| doi=10.1161/CIRCULATIONAHA.118.039410 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31155932 }} </ref> <ref name="pmid30915475">{{cite journal\| author=Cadrin-Tourigny J, Bosman LP, Nozza A, Wang W, Tadros R, Bhonsale A \| display-authors=etal\| title=A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy. \| journal=Eur Heart J \| year= 2019 \| volume= 40 \| issue= 23 \| pages= 1850-1858 \| pmid=30915475 \| doi=10.1093/eurheartj/ehz103 \| pmc=6568197 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30915475 }} </ref> <ref name="pmid32418493">{{cite journal\| author=Miron A, Lafreniere-Roula M, Steve Fan CP, Armstrong KR, Dragulescu A, Papaz T \| display-authors=etal\| title=A Validated Model for Sudden Cardiac Death Risk Prediction in Pediatric Hypertrophic Cardiomyopathy. \| journal=Circulation \| year= 2020 \| volume= 142 \| issue= 3 \| pages= 217-229 \| pmid=32418493 \| doi=10.1161/CIRCULATIONAHA.120.047235 \| pmc=7365676 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32418493 }} </ref> <ref name="pmid31411652">{{cite journal\| author=Norrish G, Ding T, Field E, Ziólkowska L, Olivotto I, Limongelli G \| display-authors=etal\| title=Development of a Novel Risk Prediction Model for Sudden Cardiac Death in Childhood Hypertrophic Cardiomyopathy (HCM Risk-Kids). \| journal=JAMA Cardiol \| year= 2019 \| volume= 4 \| issue= 9 \| pages= 918-927 \| pmid=31411652 \| doi=10.1001/jamacardio.2019.2861 \| pmc=6694401 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31411652 }} </ref> <ref name="pmid24126876">{{cite journal\| author=O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C \| display-authors=etal\| title=A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). \| journal=Eur Heart J \| year= 2014 \| volume= 35 \| issue= 30 \| pages= 2010-20 \| pmid=24126876 \| doi=10.1093/eurheartj/eht439 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24126876 }} </ref>
	**[[HCM Risk-Kids Score]] is a validated [[risk calculator]] used for [[patients]] with [[hypertrophic cardiomyopathy]] ([[HCM]]) who are up to 16 years of [[age]].		**[[HCM Risk-Kids Score]] is a validated [[risk calculator]] used for [[patients]] with [[hypertrophic cardiomyopathy]] ([[HCM]]) who are up to 16 years of [[age]].

Sudden cardiac death other diagnostic studies

2026-04-06T14:33:31Z

Postmortem Genetic Investigation:

← Older revision		Revision as of 14:33, 6 April 2026
(2 intermediate revisions by the same user not shown)
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	===Genetic testing===		===Genetic testing===
	* ~~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>.
			====== Postmortem Genetic Investigation: ======

			* Its use increased recently for research purposes and to inform family members about potentially inherited disease. It investigates the association between genotypes and etiology by autopsy.
			* Genetic studies of sudden deaths in young adults demonstrate that the genetic yield for pathogenic or likely pathogenic variants in autopsy-confirmed sudden cardiac deaths ranged from 13% to 34%.<ref name=":1">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>Christiansen SL, Hertz CL, Ferrero-Miliani L, et al. Genetic investigation of 100 heart genes in sudden unexplained death victims in a forensic setting. Eur J HumGenet.2016;24(12):1797-1802. doi:10.1038/ejhg.2016.118</ref>,<ref name=":3">Lahrouchi N, Raju H, Lodder EM, et al.Utility of post-mortem genetic testing in cases of sudden arrhythmic death syndrome.JAmCollCardiol. 2017;69(17):2134-2145. doi:10.1016/j.jacc.2017.02. 046</ref>,<ref>Hansen BL, Jacobsen EM, Kjerrumgaard A, et al. Diagnostic yield in victims of sudden cardiac death and their relatives. Europace. 2020;22(6): 964-971. doi:10.1093/europace/euaa056</ref>-,<ref name=":2">Webster G,Puckelwartz MJ,Pesce LL, et al. Genomic autopsy of sudden deaths in young individuals. JAMA Cardiol. 2021;6(11):1247-1256. doi:10.1001/jamacardio.2021.2789</ref>. These yields are obtained after careful etiologic assessment by comprehensive postmortem investigation (including toxicology) for accurate genotype-phenotype correlation.
			* Sudden arrhythmic death without an apparent cause identified by autopsy is often attributed to arrhythmia syndromes. Of 490 prospectively ascertained sudden cardiac deaths by autopsy in persons aged 1 to 35 years in Australia,<ref name=":1" /> 113 were adjudicated as sudden arrhythmic death syndrome (ie,normal structural heart) and underwent genetic testing. Clinically relevant pathogenic or likely pathogenic variants in cardiac genes were found in 27%; major associated disorders included LQTS, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy, and CPVT.
			* Another study, 103 sudden cardiac deaths defined by autopsy in persons aged 1 to 44years without known CVD referred from 24 US medical examiners’ offices identified pathogenic or likely pathogenic variants associated with dilated cardiomyopathy, hypertrophic cardiomyopathy, LQTS, and arrhythmogenic right ventricular cardiomyopathy in13%.<ref name=":2" />
			* However, the total number of eligible sudden deaths was not reported, so it is unclear how this applies to all young adults with sudden cardiac death. A single center prospective study in the UK revealed that among 303 referred family members of individuals who had sudden arrhythmic death syndrome, 128 (42%) were diagnosed with inherited cardiac diseases including Brugada syn drome,LQTS,and dilated cardiomyopathy.<ref>Papadakis M, Papatheodorou E,Mellor G, et al. The diagnostic yield of Brugada syndrome after sudden death with normal autopsy.JAmColl Cardiol. 2018;71(11):1204-1214. doi:10.1016/j.jacc. 2018.01.031</ref>

			====== Genetic Testing of Cardiac Arrest Survivors: ======
			Genetic testing of sudden cardiac arrest survivors and additional cardiac screening of family members may detect previously unknown cardiomyopathy, such as dilated cardiomyopathy, hypertrophic cardiomyopathy, or primary arrhythmia syndrome.<ref>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>,<ref name=":3" />,<ref name=":2" /> Genetic testing of survivors is recommended if the results are likely to aid diagnosis,management, or family screening (classI,level B).<ref>Stiles MK, Wilde AAM, Abrams DJ, et al.2020 APHRS/HRS exper tconsensus statement on the investigation of decedents with sudden unexplained death andpatients with sudden cardiac arrest, and of their families. Heart Rhythm. 2021;18(1):e1-e50. doi:10.1016/j.hrthm.2020.10.010</ref> However, the yield of genetic testing from studies of survivors with clinically unexplained VT/VF targeting arrhythmia and cardiomyopathy genes ranged from 2% to 22%, which is lower than the percentage of pathogenic or likely pathogenic variants in cardiac genes among those who had sudden cardiac death (ie, nonsurvivors).<ref>Mellor G, Laksman ZWM, Tadros R, et al. Genetic testing in the evaluation of unexplained cardiac arrest: from the CASPER(Cardiac Arrest Survivors With Preserved Ejection Fraction Registry). Circ Cardiovasc Genet. 2017;10(3):e001686. doi:10.1161/CIRCGENETICS.116.001686</ref><ref>Visser M, Dooijes D, van der Smagt JJ, et al. Next-generation sequencing of a large gene panel in patients initially diagnosed with idiopathic ventricular fibrillation. Heart Rhythm. 2017;14(7): 1035-1040. doi:10.1016/j.hrthm.2017.01.010</ref><ref>Leinonen JT, Crotti L, Djupsjöbacka A, et al. The genetics underlying idiopathic ventricular fibrillation: a special role for catecholaminergic polymorphic ventricular tachycardia? Int J Cardiol. 2018;250:139-145. doi:10.1016/j.ijcard.2017.10.016</ref><ref>Asatryan B, Schaller A, Seiler J, et al. Usefulness of genetic testing in sudden cardiac arrest survivors with or without previous clinical evidence of heart disease. AmJCardiol. 2019;123 (12):2031-2038. doi:10.1016/j.amjcard.2019.02.061</ref>

Sudden cardiac death prognosis

2026-04-05T12:42:38Z

Prognosis of Sudden Cardiac Death

← Older revision		Revision as of 12:42, 5 April 2026
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	==Prognosis of Sudden Cardiac ~~Death~~==		==Prognosis of Sudden Cardiac Arrest Survivors==
	*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.		*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.
	*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</ref>		*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</ref>
			*The 10-year survival rate of sudden cardiac arrest survivors aged 40 years or younger was 90% in an Australian registry.<ref>Andrew E, Nehme Z, Wolfe R, Bernard S, Smith K. Long-term survival following out-of-hospital cardiac arrest. Heart. 2017;103(14):1104-1110. doi: 10.1136/heartjnl-2016-310485</ref>The rate of recurrent arrest (both out of and in the hospital) or death in survivors aged 18 to 39 years in a Swedish registry was approximately 15% a year after the out-of-hospital cardiac arrest.<ref>Hellsén G, Rawshani A, Skoglund K, et al. Predicting recurrent cardiac arrest in individuals surviving out-of-hospital cardiac arrest. Resuscitation. 2023;184:109678. doi:10.1016/j.resuscitation.2022. 109678</ref>

			One-year overall mortality of subcutaneous ICD recipients aged 15 to 34 years was 4.3% in one cohort,90 whereas the VT or VF recurrence rate estimated by subcutaneous ICD recording in secondary prevention recipients (age not reported) in a separate study was 9.9% at 1year and15.8% at 3years.<ref>Boersma LV, Barr CS, Burke MC ,et al; EFFORTLESS and IDE Study Investigators. Performance of the subcutaneous implantable cardioverter-defibrillator in patients with a primary prevention indication with and without a reduced ejection fraction versus patients with a secondary prevention indication. Heart Rhythm. 2017;14(3): 367-375. doi:10.1016/j.hrthm.2016.11.025</ref>
	*<i><u>Factors associated poor [[prognosis]] after in-hospital [[cardiac arrest]] include</u></i>:<ref name="Chan2012">{{cite journal\|last1=Chan\|first1=Paul S.\|title=A Validated Prediction Tool for Initial Survivors of In-Hospital Cardiac Arrest\|journal=Archives of Internal Medicine\|volume=172\|issue=12\|year=2012\|pages=947\|issn=0003-9926\|doi=10.1001/archinternmed.2012.2050}}</ref><ref name="pmid21596693">{{cite journal \|vauthors=Ebell MH, Afonso AM \|title=Pre-arrest predictors of failure to survive after in-hospital cardiopulmonary resuscitation: a meta-analysis \|journal=Fam Pract \|volume=28 \|issue=5 \|pages=505–15 \|date=October 2011 \|pmid=21596693 \|doi=10.1093/fampra/cmr023 \|url=}}</ref>		*<i><u>Factors associated poor [[prognosis]] after in-hospital [[cardiac arrest]] include</u></i>:<ref name="Chan2012">{{cite journal\|last1=Chan\|first1=Paul S.\|title=A Validated Prediction Tool for Initial Survivors of In-Hospital Cardiac Arrest\|journal=Archives of Internal Medicine\|volume=172\|issue=12\|year=2012\|pages=947\|issn=0003-9926\|doi=10.1001/archinternmed.2012.2050}}</ref><ref name="pmid21596693">{{cite journal \|vauthors=Ebell MH, Afonso AM \|title=Pre-arrest predictors of failure to survive after in-hospital cardiopulmonary resuscitation: a meta-analysis \|journal=Fam Pract \|volume=28 \|issue=5 \|pages=505–15 \|date=October 2011 \|pmid=21596693 \|doi=10.1093/fampra/cmr023 \|url=}}</ref>
	:*Age > 70 years old		:*Age > 70 years old

Sudden cardiac death post arrest care and prevention

2026-04-05T12:33:04Z

2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death [2]

Show changes

Sudden cardiac death prognosis

2026-04-04T14:11:53Z

Prognosis of Sudden Cardiac Death

← Older revision		Revision as of 14:11, 4 April 2026
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	* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.		* [[Prognosis]] of in-hospital [[cardiac arrest]] is generally better than out-of- hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to [[hospital]] discharge was approximately 25% in the GWTG-R registry.
	* A retrospective cohort study from the CARES registry reported 101968 out-of-hospital cardiac arrests in the US between 2006 and 2013, approximately 6% of the incidents occurred among individuals between 20 through 39 years; survival rate to hospital discharge ranged from 11%(30-39years) to 16%(20-24years).<ref name=":0">Andersen LW, Bivens MJ,Giberson T,et al. The relationship between age and outcome in out-of-hospital cardiac arrest patients. Resuscitation. 2015;94:49-54. doi:10.1016/j.resuscitation.2015.05. 015</ref> Approximately 85% to 95% of out-of-hospital cardiac arrest survivors were discharged with good neurological outcome, as defined by a Cerebral Performance Categories scale of 1 or 2.<ref name=":0" /> <ref name=":1">Gustafsson L, Rawshani A,Råmunddal T, et al. Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden:a nationwide study. Resusc Plus. 2023;16:100503.doi:10.1016/j.resplu.2023.100503</ref>		* A retrospective cohort study from the CARES registry reported 101968 out-of-hospital cardiac arrests in the US between 2006 and 2013, approximately 6% of the incidents occurred among individuals between 20 through 39 years; survival rate to hospital discharge ranged from 11%(30-39years) to 16%(20-24years).<ref name=":0">Andersen LW, Bivens MJ,Giberson T,et al. The relationship between age and outcome in out-of-hospital cardiac arrest patients. Resuscitation. 2015;94:49-54. doi:10.1016/j.resuscitation.2015.05. 015</ref> Approximately 85% to 95% of out-of-hospital cardiac arrest survivors were discharged with good neurological outcome, as defined by a Cerebral Performance Categories scale of 1 or 2.<ref name=":0" /> <ref name=":1">Gustafsson L, Rawshani A,Råmunddal T, et al. Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden:a nationwide study. Resusc Plus. 2023;16:100503.doi:10.1016/j.resplu.2023.100503</ref>
	* The overall survival rate of young adults experiencing out-of-hospital cardiac arrest was 9% in a US study from 2005 through 2007 involving 665 persons aged 20 through 39 years, and increased to 34.8% for those with bystander-witnessed VT or VF who were more likely to receive prompt initial cardiopulmonary resus citation (CPR) or automated external defibrillator use.<ref>Rea TD, Cook AJ, Stiell IG, et al; Resuscitation Outcomes Consortium Investigators. Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements. AnnEmergMed.2010; 55(3):249-257. doi:10.1016/j.annemergmed.2009. 09.018</ref>		* The overall survival rate of young adults experiencing out-of-hospital cardiac arrest was 9% in a US study from 2005 through 2007 involving 665 persons aged 20 through 39 years, and increased to 34.8% for those with bystander-witnessed VT or VF who were more likely to receive prompt initial cardiopulmonary resus citation (CPR) or automated external defibrillator use.<ref name=":2">Rea TD, Cook AJ, Stiell IG, et al; Resuscitation Outcomes Consortium Investigators. Predicting survival after out-of-hospital cardiac arrest: role of the Utstein data elements. AnnEmergMed.2010; 55(3):249-257. doi:10.1016/j.annemergmed.2009. 09.018</ref>
	* In an Australian registry conducted between 2000 and 2009 involving 3912 patients with ages between 16 and 39 years with out-of-hospital cardiac arrest,the survival rate was 8.8%.<ref name=":1" />		* In an Australian registry conducted between 2000 and 2009 involving 3912 patients with ages between 16 and 39 years with out-of-hospital cardiac arrest,the survival rate was 8.8%.<ref name=":1" />

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	==Prognosis of Sudden Cardiac Death==		==Prognosis of Sudden Cardiac Death==
	*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.		*Prognosis of in-hospital cardiac arrest is generally better than out-of-hospital [[cardiac arrest]] and the 1-year survival rate of patients who survived to hospital discharge was approximately 25% in the GWTG-R registry.<ref name="ViraniAlonso2020">{{cite journal\|last1=Virani\|first1=Salim S.\|last2=Alonso\|first2=Alvaro\|last3=Benjamin\|first3=Emelia J.\|last4=Bittencourt\|first4=Marcio S.\|last5=Callaway\|first5=Clifton W.\|last6=Carson\|first6=April P.\|last7=Chamberlain\|first7=Alanna M.\|last8=Chang\|first8=Alexander R.\|last9=Cheng\|first9=Susan\|last10=Delling\|first10=Francesca N.\|last11=Djousse\|first11=Luc\|last12=Elkind\|first12=Mitchell S.V.\|last13=Ferguson\|first13=Jane F.\|last14=Fornage\|first14=Myriam\|last15=Khan\|first15=Sadiya S.\|last16=Kissela\|first16=Brett M.\|last17=Knutson\|first17=Kristen L.\|last18=Kwan\|first18=Tak W.\|last19=Lackland\|first19=Daniel T.\|last20=Lewis\|first20=Tené T.\|last21=Lichtman\|first21=Judith H.\|last22=Longenecker\|first22=Chris T.\|last23=Loop\|first23=Matthew Shane\|last24=Lutsey\|first24=Pamela L.\|last25=Martin\|first25=Seth S.\|last26=Matsushita\|first26=Kunihiro\|last27=Moran\|first27=Andrew E.\|last28=Mussolino\|first28=Michael E.\|last29=Perak\|first29=Amanda Marma\|last30=Rosamond\|first30=Wayne D.\|last31=Roth\|first31=Gregory A.\|last32=Sampson\|first32=Uchechukwu K.A.\|last33=Satou\|first33=Gary M.\|last34=Schroeder\|first34=Emily B.\|last35=Shah\|first35=Svati H.\|last36=Shay\|first36=Christina M.\|last37=Spartano\|first37=Nicole L.\|last38=Stokes\|first38=Andrew\|last39=Tirschwell\|first39=David L.\|last40=VanWagner\|first40=Lisa B.\|last41=Tsao\|first41=Connie W.\|title=Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association\|journal=Circulation\|volume=141\|issue=9\|year=2020\|issn=0009-7322\|doi=10.1161/CIR.0000000000000757}}</ref>.Survival after out of hospital cardiac arrest and in hospital cardiac arrest has continued to improve over time according to the guideline.
			*60% to 78% of young adults hospitalized after resuscitation from sudden cardiac arrest do not survive to hospital discharge.<ref>Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P. Out-of-hospital cardiac arrests in young adults in Melbourne,Australia. Resuscitation. 2011;82(7):830-834. doi:10.1016/j.resuscitation.2011. 03.008</ref>,<ref name=":2" />,<ref>Fovaeus H, Holmen J, Mandalenakis Z, Herlitz J, Rawshani A, Castellheim AG.Out-of-hospital cardiac arrest: survival in children and young adults over 30 years,a nationwide registry-based cohort study. Resuscitation. 2024;195:110103. doi:10.1016/ j.resuscitation.2023.110103</ref> This in-hospital mortality rate is similar to that of older adults who were resuscitated to hospitalization (≈65%).<ref>Ricceri S, Salazar JW, Vu AA, Vittinghoff E, Moffatt E, Tseng ZH. Factors predisposing to survival after resuscitation for sudden cardiac arrest. J AmColl Cardiol. 2021;77(19):2353-2362. doi:10.1016/j.jacc.2021.03.299</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===
Line 22:		Line 22:
	===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:
Line 19:		Line 23:
	** 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
(One intermediate revision by the same user not shown)
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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" />

	==References==		==References==

Sudden cardiac death electrocardiogram

2026-04-04T12:14:59Z

Brugada syndrome:

← Older revision		Revision as of 12:14, 4 April 2026
Line 38:		Line 38:
	== Brugada syndrome: ==		== 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>		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>

	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>

	==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>==