WASHINGTON — New study results reveal underlying causes of nonischemic sudden cardiac death (SCD) – those causes not related to coronary artery disease (CAD) – including alcohol, obesity and myocardial fibrosis. The study, published in the October edition of HeartRhythm, the official journal of the Heart Rhythm Society, also reinforces CAD as one of the most prevalent causes of SCD in the general population. Furthermore, the results establish specific causes of nonischemic SCD in different age groups, including people under the age of 40.
Between 1998 and 2007, postmortem examinations were performed at the Department of Forensic Medicine of the University of Oulu in Northern Finland. Causes of nonischemic SCD were analyzed separately for people younger than 40 years, between 40 and 59 years, and older than 60 years. The study data was derived from a total of 2,661 SCD victims whose death occurred based upon a population of 467,190. The autopsy rate of victims of sudden, unexpected death in Finland is relatively high allowing for large-scale, non-biased analysis of SCD causes. The autopsy data were combined with the hospital patient records and questionnaires completed by relatives of SCD victims to improve diagnostic accuracy.
Concurrent with previous studies, CAD was the most prevalent cause of SCD (78.2%), while nonischemic causes of SCD were found in 579 of the 2,661 victims (21.8%). Of the 579 victims analyzed, the most prevalent underlying causes of nonischemic SCD in the people under the age of 40 was fibrotic cardiomyopathy (CM, 28.3%), whereas alcoholic CM was the most common cause of death between 40-59 years of age (25.8%) and CM related to obesity was the most common cause of death in people older than 60 (22.8%).
“As diagnosis and treatment methods evolve over time, it is important to always look for new ways to identify and attempt to reduce the occurrence of heart related deaths in the general population,” stated co-author Heikki V. Huikuri, MD, Department of Internal Medicine Department at University of Oulu in Oulu, Finland. “The unique approach and novel findings of our study provides clinicians and patients with useful data about the potential causes of sudden cardiac death.”
Changes in lifestyle patterns, decreased physical activity and socioeconomic development, have significantly changed in recent decades, ultimately affecting the incidence of SCD. Today, obesity has become a worldwide epidemic and is often recognized as a risk for cardiac diseases. Additionally, it has been estimated that almost 4% of the global burden of disease is attributable to alcohol. As shown through this study, strategies to reduce obesity and alcohol intake may help lower the number nonischemic SCDs.
 World Health Organization: Obesity: preventing and managing the global epidemic: report of a WHO Consultation on Obesity, Geneva, 3—5 June, 1997. Geneva: World Health Organization, 1998.
 Rehm J, Taylor B, Room R. Global burden of disease from alcohol, illicit drugs and tobacco. Drug Alcohol Rev 2006; 25:503—513.
About the Heart Rhythm Society
The Heart Rhythm Society is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education and optimal health care policies and standards. Incorporated in 1979 and based in Washington, DC, it has a membership of more than 5,400 heart rhythm professionals in more than 70 countries around the world.
About HeartRhythm Journal
HeartRhythm provides rapid publication of the most important science developments in the field of arrhythmias and cardiovascular electrophysiology (EP). As the official journal of the Heart Rhythm Society, HeartRhythm publishes both basic and clinical subject matter of scientific excellence devoted to the EP of the heart and blood vessels, as well as therapy. The journal is the only EP publication serving the entire electrophysiology community from basic to clinical academic researchers, private practitioners, technicians, industry and trainees. HeartRhythm Journal has an impact factor of 4.246 (as of 2011) and ranks 23rd out of 114 cardiovascular medicine journals worldwide by the Institute for Scientific Information, remaining the number one specialty journal in cardiology. It is also the official publication of the Cardiac Electrophysiology Society.
Contact: Kennesha Baldwin
Heart Rhythm Society