Key result
Baseline ECG abnormalities, including QRS fragmentation, were not significantly more prevalent in individuals who died of sudden cardiac death before age 50 compared to matched controls.
Why the study?
Do specific ECG abnormalities predict sudden cardiac death in the general population before age 50?
Case-Control (n=48)
Triple-blind
No
Do specific ECG abnormalities predict sudden cardiac death in the general population before age 50?
Absolute Event Rate: 46% vs 67%
p-value: p=0.2
Routine ECG screening does not reliably predict sudden cardiac death in individuals under 50 years of age in the general population.
ECG screening should not guide SCD prediction under age 50; leaves open whether other markers identify risk in the general population.
Objectives: To determine the predictive value of the ECG for sudden death in the general population. Design: In the Copenhagen City Heart Study, a randomly selected population sample in Copenhagen, Denmarkhas been followed prospectively since 1976. From this population sample, we analyzed ECGs of individuals who had suffered sudden cardiac death (SCD) before the age of 50 years and compared them with ECGs of a randomly selected control individuals from the same population sample. Specific ECG signs that could point toward a condition associated with a risk of SCD were noted. Results: From a total of 18,974 individuals in the cohort, 207 had died at an age younger than 50 years. Among these, 24 persons with SCD were identified. The most prevalent ECG abnormality was QRS fragmentation. We found no ECGs with long or short QTc, Brugada sign or WPW. The prevalence of signs of left ventricular hyper-trophy, early repolarization, or fragmentation was not different from the prevalence of these signs in the control group. Conclusion: In the Copenhagen City Heart Study, the ECG failed to predict SCD in persons who died before the age of 50 years.
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Theilade et al. (2013) conducted a case-control in Sudden Cardiac Death (n=48). ECG abnormalities (e.g., QRS fragmentation) vs. Matched controls without sudden cardiac death was evaluated on Prevalence of QRS fragmentation (p=0.2). Baseline ECG abnormalities, including QRS fragmentation, were not significantly more prevalent in individuals who died of sudden cardiac death before age 50 compared to matched controls.
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