Concern at sudden cardiac death rate

By Advanced Medical Services AMS12 Nov 2010

THE INCIDENCE of sudden cardiac death (SCD) among young people in the Republic is higher than in a number of other European countries, according to a report.

The first report from the national register, set up to document all cases of SCD in those aged 15-35 in the State, says 119 deaths which occurred during the three-year period from 2005 to 2007 have been included on the register.

This gives an incidence of SCD among this age bracket of 2.68 per 100,000. The incidence among males was twice that of females.

“The incidence is higher than in other similar European studies performed in Iceland and in Sweden. The reason for this is unclear and requires further investigation,” the report says.

Dr Andrew Roy, cardiology specialist registrar at the Mater hospital, Dublin, and one of the authors of the report, said it was likely that genetic predispositions in different populations were responsible for the variations.

The overall incidence of SCD was estimated at 0.93 per 100,000 in Sweden between 1992 and 1999 among a similar age group and at 1.47 per 100,000 in Iceland.

“It is clear from these findings that SCD in the young, whilst a rare event at population level, represents a significant challenge in Ireland, with an estimated incidence of three cases every month. It can also be assumed that this figure is something of an underestimate,” the report says. Given the fact that inherited cardiac disease is known to cause cases of SCD, the importance of early family screening cannot be understated, the report adds.

Some 292 cases of possible SCD between 2005 and 2007 were examined before final figures were included in the register. Any cases where alcohol or drugs showed up in toxicology reports were excluded, which means the total numbers in the register may be an underestimation of the true extent of the problem.

Of the 119 confirmed SCD cases finally included in the register, some 46 per cent occurred while the young person was asleep. Just 8 per cent occurred while under exertion such as playing football, while the circumstances of the other 46 per cent were unknown or not stated.

Dr Roy said while SCD has traditionally been considered a young sportsperson’s illness and may have stopped some people allowing their children play, it was important to note many deaths did not occur while exercising.

A national taskforce on SCD was set up in 2004 in the wake of public concern about what appeared to be an increased incidence of sudden cardiac death among young sportsmen like the late Tyrone footballer Cormac McAnallen.

It recommended a register of all SCDs be compiled. The registry, which was set up last year, will report on sudden cardiac deaths for the years 2008 and 2009 by the end of next year and produce annual reports thereafter.