The Family Study: Assessment of the Incidence, Etiology, Circumstances and Familial Risk for Sudden Cardiac Death and Aborted Sudden Cardiac Death in Young Individuals

Background: Recent reviews have highlighted our lack of information on the incidence etiology and circumstances of sudden death (SD) in the young, particularly the distribution of underlying disorders, preventable triggers, and identifiable familial predisposition to fatal arrhythmias. Methods: This study had 3 parts: (1) the development and (2) implementation of a novel, comprehensive methodology to capture all SDs and aborted SDs (both cardiac and non-cardiac) in a defined geographic area, (3) followed by a feasibility study with a case control design. We utilized a prospectively collected, population-based registry of all out-of-hospital cardiac arrests (OHCAs) in the Greater Toronto Area, to identify patients from 2009-2012. The retrospective study included cases that were OHCAs ages 2-45, treated or untreated, died or survived and we reviewed all available data for each case and adjudicated an etiology. In the feasibility study, included cases were presumed cardiac, treated OHCAs ages 18-65. Two relatives per patient were interviewed regarding symptoms prior to the arrest, cardiac history, and family history of sudden cardiac death (SCD). Two sets of control patients were administered the same questionnaire as cases. Results: We identified 656 SCDs ages 2-45 over a 4 year period, with an overall annual incidence rate of 3.97 per 100,000 persons. We report a high autopsy rate, with a shift towards ischemic heart disease as the predominant underlying etiology in adults ages 35-45, from structural heart disease and sudden unexplained deaths in children. Adults experienced their SCDs more frequently at home and at rest than did children, and most reported new symptoms in the day preceding their event. Our feasibility studies demonstrated that it is viable to obtain a reliable family history of SCD and major cardiac risk factors from both cases and controls using a self-developed survey. Conclusions: By using a validated comprehensive population based registry of consecutive cases to identify all eligible patients, in combination with a novel classification methodology, large sample size, and multiple sources of data, we were able to better describe the nature and scope of the problem of sudden cardiac death within a young, urban Canadian population.

Department dc:contributor.department

Medical Science

Year dc:date.issued

2016

Author dc:creator

• Allan, Katherine Sarah

Advisor dc:contributor.advisor

• Dorian, Paul

• Epidimiology
• Family History
• Incidence
• Sudden Cardiac Death
• Sudden Death
• Young Individuals

Handle dc:identifier.uri

http://hdl.handle.net/1807/72935

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/72935