P6408Electrocardiographic abnormalities in young individuals who suffer sudden cardiac arrest

Abstract

Results: 588 Austrian patients in 48 centers (62±14 years; 26% female) received a WCD. Main indications were: Newly diagnosed severe non-ischemic cardiomyopathy (20%), recent myocardial infarction (19%), delayed ICD implantation (16%), ischemic cardiomyopathy with recent PCI (11%), acute myocarditis (11%), ICD-associated infection (10%). Left ventricular ejection fraction (LVEF) was 32±15%, median CHA2DS2-VASc-Score 3 (2-5). 48% of all patients had VT/VF before the WCD period. The median WCD duration was 56 (1-436) days. There was no difference in WCD compliance between patients wearing the WCD <60 days vs. >60 days (23 (3-24) h/day vs. 22 (1-24) h/day; n.s.). 23 patients (3.9%) received adequate WCD shocks for VT/VF, terminating the arrhythmia. 15 patients received an ICD, one patient received a CABG, one refused ICD Implantation, two patients died subsequently due to cardiogenic shock and four patients are still wearing the WCD. Three patients (0.5%) received an inadequate shock. Main reasons for termination of the WCD period were: ICD Implantation (48%), restitutio (26%), patient desire (4%), ablation (2%) or PCI/CABG (2%). 92 (16%) patients are still wearing the WCD. Four patients (0.7%) died during WCD period due to asystole or didn't wear the WCD at timepoint of death. Of the 63 patients with myocarditis, only nine patients (14%) required an ICD versus other 70% all over (p<0.001). Conclusion:The WCD is an effective treatment option in patients at high risk for VT/VF and/or mandated waiting period for ICD implantation. Only 48% of patients require an ICD after the WCD period. Background: Sudden cardiac arrest (SCA) in the young is a rare but devastating event. Preventive strategies are debated, but could include screening with the 12-lead ECG. However, there is a lack of community-based data regarding ECG abnormalities in young subjects who suffered SCA. Purpose: To evaluate abnormal findings on ECGs of young individuals who suffer SCA. P6408 | BEDSIDE Electrocardiographic abnormalities in young individuals Methods:We prospectively collected all 5-35-year-old SCA cases from a Northwestern US metro area (population approx. 1 million) between 2002-15. 12-lead ECGs prior and unrelated to SCA were obtained from archived medical records. For SCA survivors without prior ECG, recordings obtained at a time remote from the index hospitalization were also included. Each ECG was systematically reviewed in detail, by a clinical cardiac electrophysiologist. Results: Of the 186 young SCA cases that were ascertained, 23 (12% of all cases) had an ECG available for analysis (mean age 25±7 years, 57% female). 14 (61%) ECGs were recorded prior to arrest. 18 (78%) of the 23 ECGs were abnormal. Only 2 (9%) ECGs were completely normal, and an additional 3 ECGs had sinus tachycardia observed as the only abnormality. The most common ECG abnormalities observed were sinus tachycardia (39%), abnormal T-wave inversions (30%), prolonged QT-interval (26%), left/right atrial abnormality (22%), left ventricular hypertrophy (17%), abnorma...