Key result
Non-coronary etiologies drive ~26% of sudden cardiac death in young adults, predominantly remaining idiopathic.
Why the study?
The study aimed to characterize etiologies and outcomes of patients aged 16–65 years after resuscitated sudden cardiac death, focusing particularly on non-coronary and idiopathic cases.
What are the etiologies and outcomes of resuscitated sudden cardiac death in younger adults comparing non-coronary to coronary causes?
Cohort (n=187)
No
What are the etiologies and outcomes of resuscitated sudden cardiac death in younger adults comparing non-coronary to coronary causes?
Non-coronary and idiopathic etiologies represent a substantial proportion of sudden cardiac death in younger adults, highlighting the need for standardized post-arrest evaluation and ICD-based secondary prevention.
Answers are grounded in this paper and cite their sources.
Non-coronary and idiopathic etiologies warrant thorough evaluation in younger SCD survivors; leaves open optimal protocols for reducing recurrent arrhythmias.
Aims We aimed to characterize etiologies and outcomes of patients aged 16–65 years after resuscitated sudden cardiac death (SCD), with particular emphasis on non-coronary and idiopathic cases. Methods This retrospective single-center study screened admissions from 2010 to 2021 using ICD-10 codes followed by manual chart review. Patients were classified as having coronary, non-coronary, or unclassified etiology. Follow-up of hospital survivors included chart review, structured interviews, and device interrogation where available. Results Of 232 patients meeting the initial inclusion criteria, 187 had sufficient diagnostic information for etiological classification: 139 had coronary and 48 non-coronary causes, while 45 remained unclassified because early death or incomplete diagnostic information precluded reliable assignment. In the classified cohort, 136 patients (72.7%) experienced out-of-hospital cardiac arrest. Coronary artery disease accounted for 94.2% of coronary cases. In the non-coronary group, 54.2% remained idiopathic; identified causes included cardiomyopathies (29.2%), myocarditis (8.3%), and channelopathies (6.3%). CPR duration <10 min was associated with lower in-hospital mortality, whereas duration ≥60 min was associated with higher mortality. Of 118 hospital survivors, structured follow-up was completed in 74 patients (median 77 months). ICD implantation was more frequent in non-coronary than coronary cases (68.8% vs. 18.7%). Among 47 patients with device follow-up, appropriate ICD shocks occurred in 23.1% and 19.0%, respectively. Conclusions Non-coronary and idiopathic etiologies represent a substantial proportion of SCD in younger adults. The high proportion of unexplained cases supports standardized post-arrest evaluation, including multimodality imaging, inherited arrhythmia assessment, genetic testing, family screening, and longitudinal expert review. Recurrent ventricular arrhythmias in both groups support ICD-based secondary prevention in selected survivors.
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Thiesing et al. (2026) conducted a cohort in Resuscitated sudden cardiac death (n=187). Non-coronary etiology vs. Coronary etiology was evaluated on In-hospital mortality (p=0.227). Non-coronary etiologies accounted for 25.7% of sudden cardiac death cases in younger adults, with 54.2% remaining idiopathic, and both groups showing recurrent ventricular arrhythmias.
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