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Characteristics and clinical assessment of unexplained sudden cardiac arrest in the real-world setting: focus on idiopathic ventricular fibrillation

Waldmann, Victor ; Bougouin, Wulfran ; Karam, Nicole ; Dumas, Florence ; Sharifzadehgan, Ardalan ; Gandjbakhch, Estelle ; Algalarrondo, Vincent ; Narayanan, Kumar ; Zhao, Alexandre ; Amet, Denis ; Jost, Daniel ; Geri, Guillaume ; Lamhaut, Lionel ; Beganton, Frankie ; Ludes, Bertrand ; Bruneval, Patrick ; Plu, Isabelle ; Hidden-Lucet, Françoise ; Albuisson, Juliette ; Lavergne, Thomas ; Piot, Olivier ; Alonso, Christine ; Leenhardt, Antoine ; Lellouche, Nicolas ; Extramiana, Fabrice ; Cariou, Alain ; Jouven, Xavier ; Marijon, Eloi

European heart journal, 2018-06, Vol.39 (21), p.1981-1987 [Revista revisada por pares]

England: Oxford University Press

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Título:
Characteristics and clinical assessment of unexplained sudden cardiac arrest in the real-world setting: focus on idiopathic ventricular fibrillation
Autor: Waldmann, Victor ; Bougouin, Wulfran ; Karam, Nicole ; Dumas, Florence ; Sharifzadehgan, Ardalan ; Gandjbakhch, Estelle ; Algalarrondo, Vincent ; Narayanan, Kumar ; Zhao, Alexandre ; Amet, Denis ; Jost, Daniel ; Geri, Guillaume ; Lamhaut, Lionel ; Beganton, Frankie ; Ludes, Bertrand ; Bruneval, Patrick ; Plu, Isabelle ; Hidden-Lucet, Françoise ; Albuisson, Juliette ; Lavergne, Thomas ; Piot, Olivier ; Alonso, Christine ; Leenhardt, Antoine ; Lellouche, Nicolas ; Extramiana, Fabrice ; Cariou, Alain ; Jouven, Xavier ; Marijon, Eloi
Materias: Adult ; Aged ; Arrhythmias, Cardiac - complications ; Arrhythmias, Cardiac - diagnosis ; Cardiac Conduction System Disease - complications ; Cardiac Conduction System Disease - diagnosis ; Cardiomyopathies - complications ; Cardiomyopathies - diagnosis ; Clinical Research ; Coronary Angiography ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnosis ; Death, Sudden, Cardiac - etiology ; Echocardiography ; Editor's Choice ; Electrocardiography ; Family ; Female ; Genetic Testing ; Humans ; Life Sciences ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest - etiology ; Survivors ; Ventricular Fibrillation - complications ; Ventricular Fibrillation - diagnosis ; Ventricular Fibrillation - genetics
Es parte de: European heart journal, 2018-06, Vol.39 (21), p.1981-1987
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
PMCID: PMC5982722
See page 1988 for the editorial comment on this article (doi: 10.1093/eurheartj/ehy160)
Paris-SDEC 2016 Investigators listing (see Supplementary material online, File S2).
Xavier Jouven and Eloi Marijon authors contributed equally to the study.
Descripción: Abstract Aims Recent studies have shown that in more than half of apparently unexplained sudden cardiac arrests (SCA), a specific aetiology can be unmasked by a careful evaluation. The characteristics and the extent to which such cases undergo a systematic thorough investigation in real-life practice are unknown. Methods and results Data were analysed from an ongoing study, collecting all cases of out-of-hospital cardiac arrest in Paris area. Investigations performed during the index hospitalization or planned after discharge were gathered to evaluate the completeness of assessment of unexplained SCA. Between 2011 and 2016, among the 18 622 out-of-hospital cardiac arrests, 717 survivors (at hospital discharge) fulfilled the definition of cardiac SCA. Of those, 88 (12.3%) remained unexplained after electrocardiogram, echocardiography, and coronary angiography. Cardiac magnetic resonance imaging yielded the diagnosis in 25 (3.5%) cases, other investigations accounted for 14 (2.4%) additional diagnoses, and 49 (6.8%) patients were labelled as idiopathic ventricular fibrillation (IVF) (48.7 ± 15 years, 69.4% male). Among those labelled IVF, only 8 (16.3%) cases benefited from a complete workup (including pharmacological testing). Younger patients [odds ratio (OR) 6.00, 95% confidence interval (CI) 1.80–22.26] and those admitted to university centres (OR 3.60, 95% CI 1.12–12.45) were more thoroughly investigated. Genetic testing and family screening were initiated in only 9 (18.4%) and 12 (24.5%) cases, respectively. Conclusion Our findings suggest that complete investigations are carried out in a very low proportion of unexplained SCA. Standardized, systematic approaches need to be implemented to ensure that opportunities for specific therapies and preventive strategies (including relatives) are not missed.
Editor: England: Oxford University Press
Idioma: Inglés

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Characteristics and clinical assessment of unexplained sudden cardiac arrest in the real-world setting: focus on idiopathic ventricular fibrillation

England: Oxford University Press

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