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- W2783185306 abstract "Introduction: Sudden cardiac death (SCD) rates are higher in heart failure patients with reduced ejection fraction (HFrEF) than those with preserved EF (HFpEF), but prior studies have inferred causes of SCD from EMS records or death certificates. As ICDs only rescue from sudden arrhythmic death (SAD), it is critical to exclude non-arrhythmic causes in HF patients. We sought to determine autopsy-defined SADs in subjects with HF in a prospective comprehensive postmortem study of SCD in San Francisco (SF) County. Methods: From 2/2011 to 3/2014, all incident World Health Organization (WHO)-defined SCDs ages 18-90 were autopsied via active surveillance of consecutive out of hospital deaths in the SF POstmortem Systematic InvesTigation of Sudden Cardiac Death (POST SCD) Study. Subjects were identified to have HFpEF or HFrEF by premortem cardiac imaging and/or clinical report as part of usual care. SADs were adjudicated by a multidisciplinary committee and had no extra-cardiac cause of death or acute HF. We defined occult HF as cardiomyopathy and pulmonary edema on autopsy but no known HF premortem. Results: We autopsied 525 WHO-defined SCDs in SF over 37 months. Complete medical records were collected in 94%: 83 subjects (16%) had known HF (25 HFpEF, 58 HFrEF) and 16 (3%) had occult HF. For 61 patients (73%) with echo, mean EF for HFpEF v. HFrEF was 64% v. 36% (p Conclusions: In a comprehensive postmortem study of all incident SCDs in a metro area, 1 in 5 had clinical or occult HF. Autopsy-defined SAD accounted for three-quarters of HFrEF SCDs but less than half of HFpEF SCDs. Only HFrEF was independently associated with SAD." @default.
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- W2783185306 date "2017-11-14" @default.
- W2783185306 modified "2023-09-24" @default.
- W2783185306 title "Abstract 16858: Autopsy-Defined Causes of Sudden Death in Heart Failure With Preserved vs. Reduced Ejection Fraction in the San Francisco POstmortem Systematic InvesTigation of Sudden Cardiac Death (POST SCD) Study" @default.
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