Abstract | BACKGROUND: Between 1981 and 1988, the Centers for Disease Control and Prevention reported a very high incidence of sudden death among young male Southeast Asians who died unexpectedly during sleep. The pattern of death has long been prevalent in Southeast Asia. We carried out a study to identify the clinical markers for patients at high risk of developing sudden unexplained death syndrome (SUDS) and long-term outcomes. METHODS AND RESULTS: We studied 27 Thai men (mean age, 39.7+/-11 years) referred because they had cardiac arrest due to ventricular fibrillation, usually occurring at night while asleep (n=17), or were suspected to have had symptoms similar to the clinical presentation of SUDS (n=10). We performed cardiac testing, including EPS and cardiac catheterization. The patients were then followed at approximately 3-month intervals; our primary end points were death, ventricular fibrillation, or cardiac arrest. A distinct ECG abnormality divided our patients who had no structural heart disease (except 3 patients with mild left ventricular hypertrophy) into two groups: group 1 (n=16) patients had right bundle-branch block and ST-segment elevation in V1 through V3, and group 2 (n=11) had a normal ECG. Group 1 patients had well-defined electrophysiological abnormalities: group 1 had an abnormally prolonged His-Purkinje conduction time (HV interval, 63+/-11 versus 49+/-6 ms; P=.007). Group 1 had a higher incidence of inducible ventricular fibrillation (93% for group 1 versus 11% for group 2; P=.0002) and a positive signal-averaged ECG (92% for group 1 versus 11% for group 2; P=.002), which was associated with a higher incidence of ventricular fibrillation or death (P=.047). The life-table analysis showed that the group 1 patients had a much greater risk of dying suddenly (P=.05). CONCLUSIONS:
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Authors | K Nademanee, G Veerakul, S Nimmannit, V Chaowakul, K Bhuripanyo, K Likittanasombat, K Tunsanga, S Kuasirikul, P Malasit, S Tansupasawadikul, P Tatsanavivat |
Journal | Circulation
(Circulation)
Vol. 96
Issue 8
Pg. 2595-600
(Oct 21 1997)
ISSN: 0009-7322 [Print] United States |
PMID | 9355899
(Publication Type: Journal Article)
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Chemical References |
- Anti-Arrhythmia Agents
- Propranolol
- Amiodarone
- Potassium
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Topics |
- Adult
- Amiodarone
(therapeutic use)
- Anti-Arrhythmia Agents
(therapeutic use)
- Asia, Southeastern
(epidemiology)
- Bundle-Branch Block
(complications, drug therapy, therapy)
- Death, Sudden, Cardiac
(epidemiology, etiology)
- Defibrillators, Implantable
- Electrocardiography
- Electrophysiology
- Heart Conduction System
(physiopathology)
- Humans
- Incidence
- Male
- Potassium
(blood)
- Prevalence
- Propranolol
(therapeutic use)
- Prospective Studies
- Risk Factors
- Ventricular Fibrillation
(complications, drug therapy, therapy)
- Ventricular Function, Left
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