How to prevent SCD in the young?

Abstract

Sudden cardiac death in the young (SCDY) is always a devastating event. The death is sudden and unexpected and often in a person who was thought to be healthy. In recent years our understanding of these tragic events have drastically improved; 10-20years ago we did not know how often SCD occurred in the young, and we had sparse knowledge on the role of inheritance. We have found that SCD corresponds to 7% of all deaths with an overall (highest possible) incidence rate of 2.8 per 100,000 person-years (autopsy rate of sudden death cases of 75%). This incidence rate is higher than in the Veneto region (1.0), in the Netherlands (1.6), and in the UK (1.8), but can be explained by differences in definition and methodological factors. Cause of death in SCDY also differs to some extent between countries. Recent data suggest that there are identifiable risk factors for SCDY such as symptoms, comorbidities and polypharmacy. SCDY is to some extent preventable and this can be achieved through several initiatives: 1. better OCHA treatment including readily available AEDs, 2. family screening on the families left behind, and 3. better diagnostics and treatment for patients at risk for SCDY.