Sudden cardiac arrest related to structural non ischemic heart disease

Background Sudden cardiac arrest (SCA) is a major cause of deaths in Europe, but population-based data on specific etiologies, such as structural non ischemic heart disease (SNIHD) are lacking. Purpose We sought to determine the frequency, characteristics and outcomes of SCA associated with SNIHD in the general population. Methods In this prospective ongoing multicentre population-based registry, data from all SCA were analyzed. SNIHD included different non ischemic cardiomyopathies, as well as valvular, hypertensive and congenital heart diseases. Medical records were reviewed by cardiologists to identify clinical conditions underlying SCA. Results Of the 18,622 out-of-hospital cardiac arrests from May 2011 to May 2016, 3028 SCAs (16.2%) were admitted alive to hospital. Two hundred and twenty four (7.4%) SNIHD were diagnosed during hospitalization, including dilated cardiomyopathy (DCM) (44.2%), valvular heart disease (19.2%), hypertrophic cardiomyopathy (13.4%), myocarditis (6.7%), congenital heart disease (3.1%) and arrhythmogenic right ventricular dysplasia (2.7%). As compared to other causes of SCA, SNIHD patients were significantly younger (55.2 vs. 59.6 years, P P  = 0.003) had fewer cardiovascular risk factors (≥ 1 CVRF, 72.7% vs. 81.8%, P  = 0.002), but known heart disease was more likely to be identified (67.4% vs. 30.2%, P Conclusion In our registry, SCA associated with SNIHD presented distinctive features compared to non-SNIHD, and overall accounted for only 7% of the overall SCA burden. Main causes were DCM and valvular heart disease. Better characterization of this population, especially the sizeable subgroup with left ventricular ejection fraction > 35% can improve sudden death risk stratification in this group.