Around 1 in 10,000 people in England die of sudden cardiac death. Previous research has indicated that around 4% of these deaths are unexplained, with postmortem results highlighting normal heart function before death. William McKenna from St Georges Hospital, London, UK, and colleagues investigated whether these unexplained cases (termed sudden arrhythmic death syndrom, or SADS), could be a result of inherited heart disease.
The investigators studied the first-degree relatives (siblings, children, parents) of 32 people who had died of SADS (average age at death was 30 years). Around a quarter of families were diagnosed with inherited heart disease, either with dysfunction of the electrical cardiac system or due to heart-muscle abnormalities.
William McKenna comments: "In those families diagnosed with inherited heart disease, there had been significantly more sudden cardiac deaths among relatives than in the other families. If these sudden deaths had prompted family screening, particularly of relatives with symptoms, some of those deaths may have been prevented."
In an accompanying Commentary (p 1429), Adriana Lee and Michael J Ackerman from the Mayo Clinic, USA, conclude: "It now seems reasonable to suggest a screening 12-lead ECG for the assessment of first-degree relatives of a confirmed sudden unexplained death. However, it will often take more than just an ECG to unveil the cause of death. Further studies are needed to establish the most cost-effective standard of care for the post-death evaluation of sudden unexplained death in those left behind…With the cause in hand, physicians can allay the greatest fear, the unknown, for those whose loved one died suddenly, unexpectedly, and without explanation, and be better equipped to guide those that are left behind with informed counselling, thorough and appropriate evaluation, proper treatment, and hopefully prevention of another loss."
Contact: Professor William McKenna, c/o Helen Eldridge, British Heart Foundation Press Office;
T) 44-207-487-7172;
M) 44-776-429-0381;
E) eldridgeh@bhf.org.uk
Dr Michael Ackerman, Pediatric Cardiology, Guggenheim 501, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA;
T) 507-284-0101;
F) 507-284-3757;
E) ackerman.michael@mayo.edu
Journal
The Lancet