Primordial Symptoms and ECG Among Sudden Cardiac Death Victims Due to Primary Myocardial Fibrosis

ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Methods Fingesture study consists...

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Vydané v:	Clinical cardiology (Mahwah, N.J.) Ročník 48; číslo 7; s. e70057 - n/a
Hlavní autori:	Silvola, H., Pakanen, L., Holmström, L., Perkiömäki, J. S., Eskuri, M. A. E, Huikuri, H. V., Junttila, M. J.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States John Wiley & Sons, Inc 01.07.2025 John Wiley and Sons Inc
Predmet:	Adult Aged Cardiac arrest Cardiomyopathies - complications Cardiomyopathies - diagnosis Cardiomyopathies - mortality Cardiomyopathies - physiopathology Cardiovascular disease Cardiovascular diseases Cause of Death - trends Clinical Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - etiology Development and progression Electrocardiogram Electrocardiography Electronic health records Fainting Female Fibrosis Finland - epidemiology Heart Humans Lifesaving Male Medical records Middle Aged Myocardium - pathology Prevention Prospective Studies Risk Factors Finland
ISSN:	0160-9289, 1932-8737, 1932-8737
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Abstract	ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Methods Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Results Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Conclusions Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. Patients with primary myocardial fibrosis (PMF) may be present with abnormal ECG and/or transient loss of consciousness. Especially the combination of the two should indicate the need for further medical examination.
AbstractList	Background: Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Methods: Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Results: Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Conclusions: Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. Patients with primary myocardial fibrosis (PMF) may be present with abnormal ECG and/or transient loss of consciousness. Especially the combination of the two should indicate the need for further medical examination. Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Methods Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Results Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Conclusions Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF).BACKGROUNDSudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF).Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes.METHODSFingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes.Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC.RESULTSPrior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC.Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD.CONCLUSIONSMany SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of nonischemic SCD in young individuals in Northern Finland is primary myocardial fibrosis (PMF). Methods Fingesture study consists of 5869 prospectively collected subjects with SCD from Northern Finland collected from 1998 to 2017. Nonischemic etiology was the cause of SCD in 1477 (25%) subjects out of which primary myocardial fibrosis was the cause of SCD in 184 (12%) subjects (65% men, median age 55 ± 16 years). We examined the ante mortem ECG and medical history of the subjects to discover preceding symptoms and ECG changes. Results Prior health care contact in electronic health record system (EHR) was found for 89 (48%) subjects and ECG was available for 52 (28%) subjects. Both medical history and ECG were available for 20 subjects (11%). We observed that transient loss of consciousness (TLOC) was the most common symptom recorded and was reported by 33 (37%) subjects. ECG was abnormal in 38 (73%) subjects. Fragmented QRS (fQRS) complex was found in 26 (50%) subjects. Vast majority, 87% of subjects had either TLOC or abnormal ECG. Only seven subjects with ECG or EHR history available had normal ECG and did not have TLOC. Conclusions Many SCD victims with primary myocardial fibrosis had abnormal ECG or history of TLOC. The results suggest that the combination should generate careful cardiovascular examination to detect underlying myocardial disease and possibly prevent SCD. Patients with primary myocardial fibrosis (PMF) may be present with abnormal ECG and/or transient loss of consciousness. Especially the combination of the two should indicate the need for further medical examination.
Audience	Academic
Author	Perkiömäki, J. S. Junttila, M. J. Huikuri, H. V. Silvola, H. Pakanen, L. Eskuri, M. A. E Holmström, L.
AuthorAffiliation	1 Research Unit of Internal Medicine Medical Research Center Oulu, Oulu University Hospital, University of Oulu Oulu Finland 3 Department of Forensic Medicine, Research Unit of Internal Medicine Medical Research Center Oulu, University of Oulu Oulu Finland 2 Forensic Medicine Unit Finnish Institute for Health and Welfare Oulu Finland
AuthorAffiliation_xml	– name: 3 Department of Forensic Medicine, Research Unit of Internal Medicine Medical Research Center Oulu, University of Oulu Oulu Finland – name: 2 Forensic Medicine Unit Finnish Institute for Health and Welfare Oulu Finland – name: 1 Research Unit of Internal Medicine Medical Research Center Oulu, Oulu University Hospital, University of Oulu Oulu Finland
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Cites_doi	10.1161/CIRCEP.115.003723 10.1136/heartjnl-2019-316105 10.1161/CIRCULATIONAHA.117.032175 10.1056/NEJMra000650 10.1016/j.hrthm.2011.06.031 10.1016/S0140-6736(23)00875-9
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Snippet	ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most... Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common cause of... Background: Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most common... ABSTRACT Background Sudden cardiac death (SCD) remains a major cause of death despite progress in prevention and intervention of cardiac diseases. The most... Patients with primary myocardial fibrosis (PMF) may be present with abnormal ECG and/or transient loss of consciousness. Especially the combination of the two...
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SubjectTerms	Adult Aged Cardiac arrest Cardiomyopathies - complications Cardiomyopathies - diagnosis Cardiomyopathies - mortality Cardiomyopathies - physiopathology Cardiovascular disease Cardiovascular diseases Cause of Death - trends Clinical Death, Sudden, Cardiac - epidemiology Death, Sudden, Cardiac - etiology Development and progression Electrocardiogram Electrocardiography Electronic health records Fainting Female Fibrosis Finland - epidemiology Heart Humans Lifesaving Male Medical records Middle Aged Myocardium - pathology Prevention Prospective Studies Risk Factors
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Title	Primordial Symptoms and ECG Among Sudden Cardiac Death Victims Due to Primary Myocardial Fibrosis
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Volume	48
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