Sudden cardiac death electrocardiogram
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Sudden cardiac death Microchapters |
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Diagnosis |
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Sudden cardiac death electrocardiogram On the Web |
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Risk calculators and risk factors for Sudden cardiac death electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] José Eduardo Riceto Loyola Junior, M.D.[3] Edzel Lorraine Co, DMD, MD[4]
Overview
An electrocardiogram (ECG) may be helpful in the diagnosis of Sudden cardiac death. Findings on ECG associated with sudden cardiac arrest (SCA) include Sinus tachycardia (39%), abnormal T-wave inversions (30%), prolonged QT interval (26%), left/right atrial abnormality (22%), left ventricular hypertrophy (17%), abnormal frontal QRS axis (17%), delayed QRS-transition zone in precordial leads (13%), pathological Q waves (13%), intraventricular conduction delays (9%), multiple premature ventricular contractions (9%), normal ECG (9%).
Electrocardiogram
An electrocardiogram (ECG) may be helpful in the diagnosis of Sudden cardiac death. Findings on ECG associated with sudden cardiac arrest (SCA) may include:[1]
- Sinus tachycardia (39%)
- Abnormal T-wave inversions (30%)
- Prolonged QT interval (26%)
- Left/right atrial abnormality (22%)
- LVH (17%)
- Abnormal frontal QRS axis (17%)
- Delayed QRS-transition zone in precordial leads (13%)
- Pathological Q waves (13%)
- intraventricular conduction delays (9%)
- Multiple premature ventricular contractions (9%)
- Normal ECG (9%)
A recently published case report demonstrated a cardiac arrest happening due to a very unusual cause. It was triggered by the increased parasympathethic tone during defecation. The successive changes that were observed on ECG were in this order: prolonged PR interval, 2:1 atrioventricular block, sinus bradycardia and complete heart block. These findings supported the occurrence of a central mechanism in this cardiac arrest.[2]
2022 ESC Guidelines for the management of patients with ventricular arrythymias and the prevention of sudden cardiac death [3] [4] [5] [6] [7]
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2017AHA/ACC/HRS Guideline for management of sudden cardiac arrest and ventricular arrhythmia
| Class I (Level of Evidence: B) |
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| Class of recommendation | Level of evidence | Recommendation for ECG and exercise tredmile test |
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| 1 | B | In patients with wide complex tachycardia and hemodynamically stable, 12 leads ECG should be obtained |
| 1 | B | Exercise stress test should be obtained in patients suspected arrhythmia-related exercise such as ischemic heart disease or cathecolaminergic polymorphic ventricular tachycardia |
| 1 | B | In patients with documented ventricular arrhythmia, 12 leads ECG should be obtained during sinus rhythm for evaluation of underlying heart disease |
References
- ↑ Jayaraman, Reshmy; Reinier, Kyndaron; Nair, Sandeep; Aro, Aapo L.; Uy-Evanado, Audrey; Rusinaru, Carmen; Stecker, Eric C.; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S. (2018). "Risk Factors of Sudden Cardiac Death in the Young". Circulation. 137 (15): 1561–1570. doi:10.1161/CIRCULATIONAHA.117.031262. ISSN 0009-7322.
- ↑ Tsushima T, Patel TR, Sahadevan J (2021). "Unusual Cause of Cardiac Arrest". JAMA Intern Med. 181 (4): 542–543. doi:10.1001/jamainternmed.2020.8370. PMID 33464284 Check
|pmid=value (help). - ↑ van der Werf C, Hofman N, Tan HL, van Dessel PF, Alders M, van der Wal AC; et al. (2010). "Diagnostic yield in sudden unexplained death and aborted cardiac arrest in the young: the experience of a tertiary referral center in The Netherlands". Heart Rhythm. 7 (10): 1383–9. doi:10.1016/j.hrthm.2010.05.036. PMID 20646679.
- ↑ Behr E, Wood DA, Wright M, Syrris P, Sheppard MN, Casey A; et al. (2003). "Cardiological assessment of first-degree relatives in sudden arrhythmic death syndrome". Lancet. 362 (9394): 1457–9. doi:10.1016/s0140-6736(03)14692-2. PMID 14602442.
- ↑ Tan HL, Hofman N, van Langen IM, van der Wal AC, Wilde AA (2005). "Sudden unexplained death: heritability and diagnostic yield of cardiological and genetic examination in surviving relatives". Circulation. 112 (2): 207–13. doi:10.1161/CIRCULATIONAHA.104.522581. PMID 15998675.
- ↑ Behr ER, Dalageorgou C, Christiansen M, Syrris P, Hughes S, Tome Esteban MT; et al. (2008). "Sudden arrhythmic death syndrome: familial evaluation identifies inheritable heart disease in the majority of families". Eur Heart J. 29 (13): 1670–80. doi:10.1093/eurheartj/ehn219. PMID 18508782.
- ↑ Papadakis M, Papatheodorou E, Mellor G, Raju H, Bastiaenen R, Wijeyeratne Y; et al. (2018). "The Diagnostic Yield of Brugada Syndrome After Sudden Death With Normal Autopsy". J Am Coll Cardiol. 71 (11): 1204–1214. doi:10.1016/j.jacc.2018.01.031. PMID 29544603.
- ↑ Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". Circulation. 138 (13). doi:10.1161/CIR.0000000000000549. ISSN 0009-7322.