학술논문

Low Rate of Secondary Prevention ICDs in the General Population: Multiple-Year Multiple-Source Surveillance of Sudden Cardiac Death in the Oregon Sudden Unexpected Death Study.
Document Type
Article
Source
Journal of Cardiovascular Electrophysiology. Jan2013, Vol. 24 Issue 1, p60-65. 6p. 1 Diagram, 1 Chart, 1 Graph.
Subject
*AGE distribution
*ARRHYTHMIA
*CARDIAC arrest
*FISHER exact test
*IMPLANTABLE cardioverter-defibrillators
*LONGITUDINAL method
*RESEARCH funding
*SEX distribution
*STATISTICS
*SURVIVAL
*DATA analysis
*DATA analysis software
*DESCRIPTIVE statistics
Language
ISSN
1045-3873
Abstract
Sudden Cardiac Death. Introduction: Sudden cardiac death (SCD) is a large public health problem that warrants on-going evaluation in the general population. While single-year community-based studies have been performed there is a lack of studies that have extended evaluation to multiple years in the same community. Methods and Results: From the on-going Oregon Sudden Unexpected Death Study, we analyzed prospectively identified SCD cases in Multnomah County, Ore, (population ≈700,000) from February 1, 2002 to January 31, 2005. Detailed information ascertained from multiple sources (first responders, clinical records, and medical examiner) was analyzed. A total of 1,175 SCD cases were identified (61% male) with a mean age of 65 ± 18 years for men versus 70 ± 20 for women (P < 0.001). The overall incidence rate for the period was 58/100,000 residents/year. One-quarter (24.6%) was ≤55 years of age. The most common initial rhythm was ventricular tachycardia or fibrillation (39% of cases, survival 27%) followed by asystole (36%, survival 0.7%) and pulseless electrical activity (23%, survival 6%). Among subjects that underwent resuscitation, the rate of survival to hospital discharge was 12% and overall survival to hospital discharge irrespective of resuscitation was 8%. Of the 68 survivors, 16 (24%) received a secondary prevention ICD. Conclusion: We report annualized SCD incidence from a multiple-year, multiple-source community-based study, with higher than expected rates of women and subjects age ≤55 years. The low implantation rate of secondary prevention ICDs is likely to be multifactorial, but there are potential implications for recalibration of the projected need for ICD implantation; larger and more detailed studies are warranted. (J Cardiovasc Electrophysiol, Vol. 24, pp. 60-65, January 2013) [ABSTRACT FROM AUTHOR]