Cardiac screening detects condition tied to sudden cardiac death

A single cardiac screening has isolated a condition that appears to contribute to sudden cardiac arrest/death (SCA/SCD) in 0.3 percent of young individuals, reports a study.

Less than half of these individuals (41 percent) received risk-modifying interventions beyond lifestyle and medication, according to the authors.

A total of 104,369 consecutive individuals aged 14‒35 years (62 percent male, 89 percent White, 9 percent athletes) underwent a single screening with a questionnaire, electrocardiogram (ECG), and selective echocardiography between 2008 and 2018.

All participants had a consultation with a cardiologist who reviewed the results and recommended secondary cardiac evaluation when appropriate. The authors obtained outcomes from national databases and a follow-up questionnaire.

Of the participants, 2,629 (2.5 percent) were referred for secondary evaluation, 937 (0.9 percent) due to symptoms or family history of clinical concern, 1,361 (1.3 percent) due to an abnormal ECG, and 321 (0.3 percent) due to both.

Because of the single screening, 280 individuals (0.3 percent) were found to have conditions associated with SCA/SCD. Of these, 115 (41 percent) received risk-modifying interventions, including 10 prophylactic implantable cardioverter defibrillators and two cardiac transplants.

Eighty-six (0.08 percent) additional individuals were diagnosed with conditions related to SCA/SCD, including 35 who had SCA (n=15) or SCD (n=20), over a mean follow-up of 6.0 years. The SCA/SCD incidence was 5.6 per 100,000 person-years, with a median age of presentation of 23.8 years. The events occurred at a median of 3.6 years after screening.

ECG and the questionnaire for detecting conditions associated with SCA/SCD had a sensitivity of 75.4 percent and 32.5 percent, respectively.

“The incidence of SCA/SCD was 5.6 per 100,000 person-years, underscoring the need to strengthen strategies for the prevention of SCD in young individuals,” the authors said. “Serial evaluations may mitigate the challenge of age-related penetrance.”