Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Sudden Death in Pediatric Populations

  • Wu, Mei-Hwan (Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University)
  • Published : 2010.06.30
⟨ Previous Next ⟩

Abstract

Sudden death (SD) in children is rarer than in adults. In the pediatric population, SD accounts for less than one tenth of deaths from all causes. SD in infants is a separate entity commonly termed "sudden infant death syndrome (SIDS)". Previous studies on SD in pediatric patients primarily focused on infants and showed that the incidence of SIDS was much lower in Asian countries than in Western ones. However, these differences diminished after educational campaigns such as the back to sleep act in the late 1980s to early 1990s. The incidence of SIDS from Western reports has decreased from 2.69 to around 0.5-0.24 per 1,000 live births. Beyond infancy, the annual incidence of SD ranges from 1.3 to 7.5 per 100,000. In 2009, two population-based studies, one from Taiwan and the other from the US, explored the epidemiological profile of SD in children. The child health care indexes of these two countries are similar, but the annual incidence of pediatric SD was 7.5 and 2.7 per 100,000 in the USA and Taiwan, respectively. The implications of ethic-related differences requires further confirmation. Around 40% of pediatric SD could be from cardiac causes, either diagnosed or undiagnosed. Risk stratification for cardiac SD and patient selection for implantable cardioverter-defibrillator (ICD) therapy are recommended. However, the adoption of ICD as primary prevention for SD in children is still a challenging issue. Early detection of undiagnosed cardiac risk may be facilitated by cardiac screening either in newborns or the school-age population to better manage the risk of SD. However, the efficacy of such screening remains still controversial.

Keywords

References

  1. Wren C, O'Sullivan JJ, Wright C. Sudden death in children and adolescents. Heart 2000;83;410-3. https://doi.org/10.1136/heart.83.4.410
  2. Molander N. Sudden natural death in later childhood and adolescence. Arch Dis Child 1982;57:572-6. https://doi.org/10.1136/adc.57.8.572
  3. Driscoll DJ, Edwards WD. Sudden unexpected death in children and adolescents. J Am Coll Cardiol 1985;5(6 Suppl):118B-21B. https://doi.org/10.1016/S0735-1097(85)80540-4
  4. Neuspiel DR, Kuller LH. Sudden and unexpected natural death in childhood and adolescence. JAMA 1985;254:1321-5. https://doi.org/10.1001/jama.254.10.1321
  5. Wu MH, Wu MH, Chen HC, Wang JK, Huang SC, Huang SK. Population-based study of pediatric sudden death in Taiwan. J Pediatr 2009;155:870-4.e2. https://doi.org/10.1016/j.jpeds.2009.06.038
  6. Chugh SS, Reinier K, Balaji S, et al. Population-based analysis of sudden death in children: the Oregon sudden unexpected death study. Heart Rhythm 2009;6:1618-22. https://doi.org/10.1016/j.hrthm.2009.07.046
  7. Priori SG, Aliot E, Blomstrom-Lundqvist C, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 2001;22:1374-450. https://doi.org/10.1053/euhj.2001.2824
  8. Zheng ZJ, Croft JB, Giles WH, Mensah GA. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001;104:2158- 63. https://doi.org/10.1161/hc4301.098254
  9. Straus SM, Bleumink GS, Dieleman JP, van der Lei J, Stricker BH, Sturkenboom MC. The incidence of sudden cardiac death in the general population. J Clin Epidemiol 2004;57:98-102. https://doi.org/10.1016/S0895-4356(03)00210-5
  10. Behr ER, Casey A, Sheppard M, et al. Sudden arrhythmic death syndrome: a national survey of sudden unexplained cardiac death. Heart 2007;93:601-5. https://doi.org/10.1136/hrt.2006.099598
  11. Niimura I, Maki T. Sudden cardiac death in childhood. Jpn Circ J 1989;53:1571-80. https://doi.org/10.1253/jcj.53.1571
  12. Adams EJ, Chavez GF, Steen D, Shah R, Ivasu S, Krous HF. Changes in the epidemiologic profile of sudden infant death syndrome as rates decline among California infants: 1990-1995. Pediatrics 1998;102:1445-51. https://doi.org/10.1542/peds.102.6.1445
  13. Daltveit AK, Oyen N, Skjærven R, Irgens LM. The epidemic of SIDS in Norway 1967-93: changing effects of risk factors. Arch Dis Child 1997;77:23-7. https://doi.org/10.1136/adc.77.1.23
  14. Arnestad M, Andersen M, Vege A, Rognum TO. Changes in the epidemiological pattern of sudden infant death syndrome in southeast Norway, 1984-1998: implications for future prevention and research. Arch Dis Child 2001;85:108-15. https://doi.org/10.1136/adc.85.2.108
  15. Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet 2007;370:1578-87. https://doi.org/10.1016/S0140-6736(07)61662-6
  16. Sawaguchi T, Nelson EA, Fujita T, Sawaguchi A, Knight B. Is the incidence of SIDS increasing in Asia? Int J Legal Med 1998; 111:278-80. https://doi.org/10.1007/s004140050170
  17. Lee CL, Chang TL. The trend of sudden infant death syndrome in Taiwan from 1984 to 1993. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1995;36:431-3.
  18. Sawaguchi T, Namiki M. Recent trend of the incidence of sudden infant death syndrome in Japan. Early Hum Dev 2003;75(Suppl): S175-9. https://doi.org/10.1016/j.earlhumdev.2003.08.020
  19. Ha M, Yoon SJ, Lee HY, Goh UY, Kim CH, Lee YS. Estimation of the incidence of sudden infant death syndrome in Korea: using the capture-recapture method. Paediatr Perinat Epidemiol 2004; 18:138-42. https://doi.org/10.1111/j.1365-3016.2003.00544.x
  20. Lee NN, Chan YF, Davies DP, Lau E, Yip DC. Sudden infant death syndrome in Hong Kong: confirmation of low incidence. BMJ 1989;298:721. https://doi.org/10.1136/bmj.298.6675.721
  21. Knöbel HH, Yang WS, Chen CJ. Sudden infant death syndrome among Chinese. Lancet 1994;344:820.
  22. Hauck FR, Tanabe KO. International trends in sudden infant death syndrome: stabilization of rates requires further action. Pediatrics 2008;122:660-6. https://doi.org/10.1542/peds.2007-0135
  23. Morentin B, Aguilera B, Garamendi PM, Suarez-Mier MP. Sudden unexpected non-violent death between 1 and 19 years in north Spain. Arch Dis Child 2000;82:456-61. https://doi.org/10.1136/adc.82.6.456
  24. Maron BJ, Shirani J, Poliac LC, Matenge R, Roberts WC, Mueller FO. Sudden death in young competitive athletes: clinical, demographic, and pathological profiles. JAMA 1996;276:199-204. https://doi.org/10.1001/jama.276.3.199
  25. Keeling JW, Knowles SA. Sudden death in childhood and adolescence. J Pathol 1989;159:221-4. https://doi.org/10.1002/path.1711590308
  26. Liberthson RR. Sudden death from cardiac causes in children and young adults. N Engl J Med 1996;334:1039-44. https://doi.org/10.1056/NEJM199604183341607
  27. Wren C. Sudden death in children and adolescents. Heart 2002; 88:426-31. https://doi.org/10.1136/heart.88.4.426
  28. Silka MJ, Hardy BG, Menashe VD, Morris CD. A populationbased prospective evaluation of risk of sudden cardiac death after operation for common congenital heart defects. J Am Coll Cardiol 1998;32:245-51. https://doi.org/10.1016/S0735-1097(98)00187-9
  29. Khairy P, Harris L, Landzberg MJ, et al. Implantable cardioverter- defibrillators in tetralogy of Fallot. Circulation 2008;117: 363-70. https://doi.org/10.1161/CIRCULATIONAHA.107.726372
  30. Khairy P, Landzberg MJ, Gatzoulis MA, et al. Value of programmed ventricular stimulation after tetralogy of Fallot repair: a multicenter study. Circulation 2004;109:1994-2000. https://doi.org/10.1161/01.CIR.0000126495.11040.BD
  31. Kugler JD. Predicting sudden death in patients who have undergone tetralogy of Fallot repair: is it really as simple as measuring ECG intervals? J Cardiovasc Electrophysiol 1998;9:103-6. https://doi.org/10.1111/j.1540-8167.1998.tb00873.x
  32. Silka MJ, Kron J, Dunnigan A, Dick M 2nd. Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. The Pediatric Electrophysiology Society. Circulation 1993;87:800-7. https://doi.org/10.1161/01.CIR.87.3.800
  33. Harrison DA, Connelly M, Harris L, Luk C, Webb GD, McLaughlin PR. Sudden cardiac death in the adult congenital heart disease. Can J Cardiol 1996;12:1161-3.
  34. Sakazaki H, Niwa K, Echigo S, Akagi T, Nakazawa M. Predictive factors for long-term prognosis in adults with cyanotic congenital heart disease: Japanese multi-center study. Int J Cardiol 2007; 120:72-8. https://doi.org/10.1016/j.ijcard.2006.08.081
  35. Hamada H, Terai M, Jibiki T, Nakamura T, Gatzoulis MA, Niwa K. Influence of early repair of tetralogy of Fallot without an outflow patch on late arrhythmias and sudden death: a 27-year follow- up study following a uniform surgical approach. Cardiol Young 2002;12:345-51. https://doi.org/10.1017/S1047951100012944
  36. Wu MH, Chen HC, Lu CW, Wang JK, Huang SC, Huang SK. Prevalence of congenital heart disease at live birth in Taiwan. J Pediatr 2010. [Epub ahead of print]
  37. Yetman AT, Hamilton RM, Benson LN, McCrindle BW. Longterm outcome and prognostic determinants in children with hypertrophic cardiomyopathy. J Am Coll Cardiol 1998;32:1943-50. https://doi.org/10.1016/S0735-1097(98)00493-8
  38. Elliot P, Poloniecki J, Dickie S, et al. Sudden death in hypertrophic cardiomyopathy: identification of high risk patients. J Am Coll Cardiol 2000;36:2212-8. https://doi.org/10.1016/S0735-1097(00)01003-2
  39. Arola A, Jokinen E, Ruuskanen O, et al. Epidemiology of idiopathic cardiomyopathies in children and adolescents: a nationwide study in Finland. Am J Epidemiol 1997;146:385-93. https://doi.org/10.1093/oxfordjournals.aje.a009291
  40. Chiu SN, Wang JK, Wu MH, et al. Cardiac conduction disturbance detected in a pediatric population. J Pediatr 2008;152:85-9. https://doi.org/10.1016/j.jpeds.2007.05.044
  41. Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation 2009;119:1085-92. https://doi.org/10.1161/CIRCULATIONAHA.108.804617
  42. Vetter VL. The role of ECG screening in the evaluation of risk of sudden cardiac arrest in the young. Pacing Clin Electrophysiol 2009;32(Suppl 2):S6-14. https://doi.org/10.1111/j.1540-8159.2009.02379.x
  43. Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation 2007;116: 2616-26. https://doi.org/10.1161/CIRCULATIONAHA.107.733519
  44. Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation 2007;116:2610-4. https://doi.org/10.1161/CIRCULATIONAHA.107.711465
  45. Montoya PT, Brugada P, Smeets J, et al. Ventricular fibrillation in the Wolff-Parkinson-White syndrome. Eur Heart J 1991;12: 144-50. https://doi.org/10.1093/eurheartj/12.suppl_D.144
  46. Munger TM, Packer DL, Hammill SC, et al. A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989. Circulation 1993;87:866-73. https://doi.org/10.1161/01.CIR.87.3.866
  47. Friedman RA, Walsh EP, Silka MJ, et al. NASPE Expert Consensus Conference: radiofrequency catheter ablation in children with and without congenital heart disease. Report of the writing committee. North American Society of Pacing and Electrophysiology. Pacing Clin Electrophysiol 2002;25:1000-17. https://doi.org/10.1046/j.1460-9592.2002.01000.x
  48. Goldenberg I, Moss AJ. Long QT syndrome. J Am Coll Cardiol 2008;51:2291-300. https://doi.org/10.1016/j.jacc.2008.02.068
  49. Schwartz PJ, Stramba-Badiale M, Crotti L, et al. Prevalence of the congenital Long-QT syndrome. Circulation 2009;120:1761-7. https://doi.org/10.1161/CIRCULATIONAHA.109.863209
  50. Goldenberg I, Moss AJ, Peterson DR, et al. Risk factors for aborted cardiac arrest and sudden cardiac death in children with the congenital long-QT syndrome. Circulation 2008;117:2184-91. https://doi.org/10.1161/CIRCULATIONAHA.107.701243
  51. Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. J Am Coll Cardiol 2008;51:e1-62. https://doi.org/10.1016/j.jacc.2008.02.032
  52. Berul CI, Van Hare GF, Kertesz NJ, et al. Results of a multicenter retrospective implantable Cardioverter-defibrillator registry of pediatric and congenital heart disease patients. J Am Coll Cardiol 2008;51:1685-91. https://doi.org/10.1016/j.jacc.2008.01.033

Cited by

  1. Clinical Significance of Thrombosis in an Intracardiac Blind Pouch After a Fontan Operation vol.33, pp.1, 2010, https://doi.org/10.1007/s00246-011-0074-x
  2. Sudden and unexpected and near death during the early neonatal period: A multicenter study vol.75, pp.2, 2010, https://doi.org/10.1016/j.jcma.2011.12.009
  3. Sudden Cardiac Arrest in a Young Patient with Hypertrophic Cardiomyopathy and Zero Canonical Risk Factors: The Inherent Limitations of Risk Stratification in Hypertrophic Cardiomyopathy : Zero Risk Fa vol.9, pp.2, 2010, https://doi.org/10.1111/chd.12073
  4. Is There a Role for the Microbiome and Sudden Death? A Systematic Review vol.11, pp.12, 2010, https://doi.org/10.3390/life11121345