Prevented Sudden Cardiac Death and Neurologic Recovery in Inherited Heart Diseases

• Main Authors: Juan P. Hernández del Rincón, Mari C. Olmo Conesa, Ana Rodríguez Serrano, Helena García Pulgar, David López Cuenca, Carmen Muñoz Esparza, Marina Navarro Peñalver, Juan José Santos Mateo, Elisa Nicolás Rocamora, Cristina Gil Ortuño, María Sabater-Molina, Juan Ramón Gimeno Blanes, Francisco Pastor Quirante
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-03-01
• Series: Frontiers in Cardiovascular Medicine
• Subjects: sudden cardiac death; cardiomyopathy; channelopathy; inherited cardiovascular diseases; prevented sudden cardiac death
• Online Access: https://www.frontiersin.org/articles/10.3389/fcvm.2021.634300/full

Introduction: Inherited cardiovascular diseases are an important cause of sudden cardiac death (SD). The use of risk scores identify high risk patients who would benefit from an implantable cardioverter-defibrillators (ICDs). The development of automated devices for out-of-hospital cardiac arrest improves early resuscitation. The objective of the study is to quantify prevented SD and the neurological recovery of patients with inherited cardiovascular diseases.Methods: Two hundred fifty-seven cases of SD (age 42 ± 18 years, 79.4% men) of non-ischemic cardiac cause were prospectively collected during the study period (2009–17). Fifty three (20.6%) had a resuscitated cardiac arrest (RCA) (age 40 ± 18 years, 64.2% male). Epidemiological, clinical and autopsy aspects were analyzed. Prevented SD was defined as a combination of RCA and appropriate ICD therapy cases.Results: An autopsy was performed in 157/204 (77.0%) cases who died. There were 19 (12.1%) cases with a negative autopsy. The diagnosis of cardiomyopathy and channelopathy was 58.0 and 18.7%, respectively. Female sex and confirmed or suspected channelopathy were associated with successful resuscitation. The percentage of prevented SD remained low during the study period (mean 35.6%). 60.4% of RCA cases presented good neurological outcome. There was no association between neurological recovery and therapeutic hypothermia, but there was association with time of resuscitation (min).Conclusion: A fifth part of non-ischemic cardiac arrests were resuscitated. Female sex and channelopathies were more prevalent among RCA. Two thirds of RCA had a good neurological recovery.