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. 2023 Jun 12;39(4):607-612.
doi: 10.1002/joa3.12881. eCollection 2023 Aug.

The role of genetic testing in the prevention, diagnosis, and prognosis of sudden cardiac arrest in children

Miry Blich  1   2 , Hodaya Oron  1 , Wisam Darawsha  2 , Mahmoud Suleiman  2 , Lior Gepstein  2 , Monther Boulos  2 , Avraham Lorber  3 , Asaad Kchoury  3
Affiliations

The role of genetic testing in the prevention, diagnosis, and prognosis of sudden cardiac arrest in children

Miry Blich et al. J Arrhythm. .

Abstract

Background: Determining the pathogenesis of sudden cardiac arrest (SCA) in children is crucial for its management and prognosis. Our aim is to analyze the role of broad genetic testing in the prevention, diagnosis, and prognosis of SCA in Children.

Methods: ECG, 12-lead holter, exercise testing, cardiac imaging, familial study, and genetic testing were used to study 29 families, in whom a child experienced SCA.

Results: After a thorough clinical and genetic evaluation a positive diagnosis was reached in 24/29 (83%) families. Inherited channelopathies (long QT syndrome and catecholaminergic polymorphic ventricular tachycardia) were the most prevalent 20/29 (69%) diagnosis, followed by cardiomyopathy 3/29 (10%). Broad genetic testing was positive in 17/24 (71%) cases. Using the Mann-Whitney test, we found that genetic testing (effect size = 0.625, p = 0.003), ECG (effect size = 0.61, p = 0.009), and exercise test (effect size = 0.63, p = 0.047) had the highest yield in reaching the final diagnosis. Genetic testing was the only positive test available for five (17%) families. Among 155 family members evaluated through cascade screening, 73 (47%) had a positive clinical evaluation and 64 (41%) carried a pathologic mutation. During 6 ± 4.8 years of follow-up, 58% of the survived children experienced an arrhythmic event. Of nine family members who had an ICD implant for primary prevention, four experienced appropriate ICD shock.

Conclusions: The major causes of SCA among children are genetic etiology, and genetic testing has a high yield. Family screening has an additional role in both the diagnosis and preventing of SCA.

Keywords: children; sudden cardiac arrest.

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Conflict of interest statement

Authors declare no conflict of interests for this article.

Figures

FIGURE 1
FIGURE 1
Final diagnosis after clinical and genetic evaluation in children experienced aborted and non‐aborted SCD, at an inherited arrhythmia clinic n = 29. CPVT, catecholaminergic polymorphic ventricular tachycardia; DCM, dilated cardiomyopathy; HCM, hypertrophic cardiomyopathy; LQTS, long QT syndrome.
FIGURE 2
FIGURE 2
Genetic diagnosis in families with probable causative mutation, n = 17.
See this image and copyright information in PMC

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