Author + information
- ↵*Address for reprints: Arthur Garson, Jr., MD, Pediatric Cardiology, Texas Children's Hospital, 6621 Fannin, Houston, Texas 77030.
This review of sudden death in patients previously seen in a pediatric cardiology clinic attempts to identify factors that may have been predictive of sudden death. The denominator for these factors is unknown. For example, the number of patients with these possible risk factors who have well tolerated arrhythmias is not known. Further studies are planned to document the incidence of these factors in patients with similar lesions whom we continue to follow up.
The following conclusions can be drawn from the study: 1) More than three-quarters of the patients who died suddenly had severe limitation of activity, cardiac enlargement on chest radiograph or poor hemodynamic status at cardiac catheterization. 2) The majority of patients who died suddenly had an arrhythmia in the 12 month period before death. A significant number of these arrhythmias developed for the first time in the year before death. 3) The presence of arrhythmias was generally related to poor hemodynamic status in patients who died suddenly. 4) Most sudden deaths occurred with the patient at rest and only approximately one-quarter occurred during participation in sports. 5) Each cardiac diagnosis had its own specific profile of types of arrhythmias. 6) Conspicuously absent from the list of diagnoses were children with a normal heart and children with mitral valve prolapse. 7) With improvement in treatment practices (more aggressive drug treatment of ventricular arrhythmias and more aggressive pacemaker treatment of bradyarrhythmias in the last 5 years), the incidence of sudden death at this institution has been reduced significantly from that in previous years.
- American College of Cardiology Foundation