[Sudden death due to electrical causes in individuals without demonstrable structural cardiac disease. Experience in Cuba].
Sudden cardiac death due to electrical causes in individuals with no evidence of structural heart disease is an important clinical and public health problem, and it is not yet solved. The objectives of this study were: to characterize patients reanimated from a sudden death event of electrical cause; to know the mediated evolution during a period of three years and to study premonitory electrical signs. 42 individuals were studied, 30 were male and 12 female, mean age 37.7 years, healthy heart, by clinic and paraclinic methods. Nine subpopulations were studied, being Brugada syndrome, long QT syndrome and idiopathic ventricular fibrillation the most frequent. Ventricular fibrillation and twisting of the points were the arrhythmias responsible for most death events. There were premonitory signs in 92.8% and clinical recurrences of life-threatening events in 71.4% but they were induced during programmed electrical stimulation only in 4 of 18 patients. Atrial fibrillation was the most frequent coexistent arrhythmia (19%). In summary, there are frequent premonitory signs (particularly atrial fibrillation), and also malignant arrhythmic recurrences but a poor inducibility at the electrophysiology laboratory. It is very difficult to stratify the risk because of the low predictive value of diagnostic methods.
Sánchez
Margarita Dorantes
MD
Instituto de Cardiología y Cirugía Cardiovascular, Ciudad de la Habana, Cuba. dorantes@infomed.sld.cu
Hevia
Jesús Castro
JC
Bárzaga
Francisco Tornés
FT
Pérez
Miguel Angel Quiñones
MA
Molina
Roberto Zayas
RZ
Balea
Francisco Dorticós
FD
D000293:Adolescent; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003462:Cuba / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D012307:Risk Factors
D000889:Anti-Arrhythmia Agents