Reevaluation of ECGs of a German non coronary sudden cardiac arrest cohort

While primarily a disease of older adults due to coronary artery disease, sudden cardiac arrest (SCA) also affects younger individuals, particularly those with genetic predispositions or congenital heart defects. This study aimed to systematically investigate SCA in younger patients (aged ≤ 65 years), focusing on non-coronary artery-related causes. Patients admitted due to SCA or acute resuscitation scenarios at the University Hospital Bergmannsheil in Bochum, Germany, between 2010 and 2021, were comprehensively investigated. Patients were categorized into groups based on their diagnosed etiology, with non-coronary causes being the primary focus of this analysis. 232 patients with SCA were included. The median age was 52 years, 66.7% were male. The causes were idiopathic (54.2%), cardiomyopathies (29.2%), myocarditis (8.3%), valve diseases (2.1%) and channelopathies (6.3%). Two independent cardiologists reviewed all ECGs, at least two from each case. Post-resuscitation ECG analysis identified Short- and Long-QT-syndrome in two patients previously classified as idiopathic SCA. SCA was witnessed by bystanders in 87.5% of cases, with layperson cardiopulmonary resuscitation in 45.8%. SCA occurred predominantly at home (37.5%) and in public places (29.2%). In-hospital mortality was 29.2%. During a mean follow-up of 53.2 ± 7.3 months, three patients died. ICDs documented ventricular tachyarrhythmias in nine patients. This study comprehensively analyzed 48 non-coronary SCA patients from a cohort of 232 SCA cases. A case of short QT syndrome and a case of long-QT syndrome was identified in an SCA cohort, emphasizing the importance of repeated ECG analysis after cardiac arrest.