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September 8, 2026IJC Heart & VasculatureOpen Access

Non-coronary SCD cases experience appropriate ICD shocks at a ~23% rate versus coronary etiologies.

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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 long-term outcomes of younger adults (16-65 years) after resuscitated sudden cardiac death?

Population

232 patients aged 16–65 years after resuscitated sudden cardiac death

Comparison

Coronary vs non-coronary etiologies

Design

Retrospective single-center study

Follow-up

Median 77 months

Key result

Non-coronary etiologies accounted for 48 of 187 classified sudden cardiac death cases, with appropriate ICD shocks occurring in 23.1% compared to 19.0% in coronary cases during follow-up.

Authors

PTPia ThiesingASAndreas SmitHMHendrik Milting

Discussion

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Overview

Etiologies of resuscitated SCD in young adults remain heterogeneous; this cohort study leaves open whether non-coronary or idiopathic cases warrant distinct evaluation protocols.

Key Points

  • To characterize the underlying causes and long-term clinical outcomes in individuals aged 16–65 years surviving resuscitated sudden cardiac death, with an emphasis on non-coronary and idiopathic origins.
  • Conducted a retrospective single-center review of 232 patients aged 16–65 admitted after resuscitated sudden cardiac death between 2010 and 2021.
  • Categorized cases into coronary, non-coronary, or unclassified etiologies via ICD-10 screening and comprehensive medical chart review.
  • Evaluated hospital survivors over a median follow-up of 77 months using structured interviews, chart reviews, and cardiac device interrogations.
  • Of 187 fully classified cases, coronary artery disease caused 94.2% of coronary events (n=139), whereas non-coronary events (n=48) were idiopathic in 54.2%, cardiomyopathies in 29.2%, myocarditis in 8.3%, and channelopathies in 6.3%.
  • Cardiopulmonary resuscitation duration under 10 minutes was associated with lower in-hospital mortality, while duration of 60 minutes or greater was associated with higher mortality.
  • ICD implantation occurred more frequently in non-coronary than coronary survivors (68.8% vs. 18.7%), with appropriate ICD shocks recorded in 23.1% of non-coronary and 19.0% of coronary recipients.

Study Design

Type

Cohort (n=232)

Multicenter

No

Structured PICO

What are the etiologies and long-term outcomes of younger adults (16-65 years) after resuscitated sudden cardiac death?

P
Population
232 patients aged 16-65 years with resuscitated sudden cardiac death, followed for a median of 77 months among survivors.
C
Comparator
Coronary vs. non-coronary etiologies
O
Outcome
Etiologies of sudden cardiac death and clinical outcomes including in-hospital mortality, ICD implantation rates, and appropriate ICD shockshard clinical

Main Result

Absolute Event Rate: 23.1% vs 19%

Non-coronary and idiopathic etiologies account for a substantial proportion of sudden cardiac death in younger adults, with high rates of recurrent ventricular arrhythmias supporting the use of ICDs for secondary prevention.

Limitations

  • Early death or incomplete diagnostic information precluded reliable etiological assignment in 45 cases

Cite This Study

Thiesing et al. (2026) conducted a cohort in Resuscitated sudden cardiac death (SCD) (n=232). Non-coronary etiology vs. Coronary etiology was evaluated on Appropriate ICD shocks during follow-up. Non-coronary etiologies accounted for 48 of 187 classified sudden cardiac death cases, with appropriate ICD shocks occurring in 23.1% compared to 19.0% in coronary cases during follow-up.

synapsesocial.com/papers/6aa0091858e84d0ff5b47be6https://doi.org/10.1016/j.ijcha.2026.102009
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