[I-AHAJS-03] Does Heart Disease Screening Contribute to Preventing Sudden Cardiac Arrest in School Children?
Background: In Japan, heart disease screening for school-age children (range: 6 to 18 years) began in the 1960s. We discuss the contribution of this system to the prevention of sudden cardiac arrest in students under school supervision.
Methods: We analyzed reports of sudden cardiac death and resuscitated cardiac arrest registered in the Mutual Aid System for school-age children in Japan between 2008 and 2016, and reviewed whether the causative disease was identified by screening, to compare the resuscitation prognosis between diseases.
Results: We analyzed data for 467 children experiencing cardiac arrest; 152 died, and 315 were resuscitated. In 159 children, no causative disease was found even with forensic autopsies or hospital examinations. Idiopathic ventricular fibrillation was considered the underlying cause in 144 children because of the absence of any prior diagnosis and no record of defibrillator use. Twenty-five of 48 children with cardiomyopathy, 24 with congenital structural diseases, 11 with long-QT syndrome, six with Wolff–Parkinson–White syndrome, 4/11 children with aortic dissection, and 15 children with other arrhythmias or electrocardiographic abnormalities were diagnosed with screening, and school activity was managed in most children. However, 23 children with cardiomyopathy, 21 with coronary artery disease, and seven with aortic dissection were not diagnosed nor expected by the screening system.
Discussion: We compared the resuscitation rate for each underlying disease, and we suggested appropriate strategies to prevent sudden cardiac death for each heart disease.
Methods: We analyzed reports of sudden cardiac death and resuscitated cardiac arrest registered in the Mutual Aid System for school-age children in Japan between 2008 and 2016, and reviewed whether the causative disease was identified by screening, to compare the resuscitation prognosis between diseases.
Results: We analyzed data for 467 children experiencing cardiac arrest; 152 died, and 315 were resuscitated. In 159 children, no causative disease was found even with forensic autopsies or hospital examinations. Idiopathic ventricular fibrillation was considered the underlying cause in 144 children because of the absence of any prior diagnosis and no record of defibrillator use. Twenty-five of 48 children with cardiomyopathy, 24 with congenital structural diseases, 11 with long-QT syndrome, six with Wolff–Parkinson–White syndrome, 4/11 children with aortic dissection, and 15 children with other arrhythmias or electrocardiographic abnormalities were diagnosed with screening, and school activity was managed in most children. However, 23 children with cardiomyopathy, 21 with coronary artery disease, and seven with aortic dissection were not diagnosed nor expected by the screening system.
Discussion: We compared the resuscitation rate for each underlying disease, and we suggested appropriate strategies to prevent sudden cardiac death for each heart disease.