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Declining Trend of Sudden Cardiac Death in Younger Individuals: A 20-Year Nationwide Study

Circulation

BACKGROUND:Declining cardiovascular mortality rates have been well-documented, yet temporal trends of sudden cardiac death (SCD) in young individuals remain unclear.

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Early repolarization in the left posterior leads of the electrocardiogram: A new challenge for the existence of idiopathic ventricular fibrillation

HeartRhythm

A few decades ago all sudden cardiac arrests with documented ventricular fibrillation (VF) and structurally normal hearts were diagnosed as idiopathic ventricular fibrillation (IVF).

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Brugada Syndrome: Diagnosis and Risk Stratification

All About Cardiovascular System and Disorders

Brugada syndrome is thought to account for about one fourth of sudden cardiac deaths in individuals with structurally normal heart. Even though mutations in other channels have been described in Brugada syndrome, only those in SCN5A gene are considered to be definitely disease causing. mV or R/q ≥ 0.75.

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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias. See more cases of Brugada due to fever here. Heart Rhythm, 15(9): 1394-1401. [7]

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

The limb lead abnormalities appear to be part of the Brugada pattern, as described in this article: Inferior and Lateral Electrocardiographic RepolarizationAbnormalities in Brugada Syndrome Discussion Brugada Type 1 ECG changes are associated with sudden cardiac death (SCD) and the occurrence of ventricular dysrhythmias.

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A young F is hyperthermic, delirious, and dry: Fever-induced Brugada? Diphenhydramine toxicity? Tricyclic?

Dr. Smith's ECG Blog

Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had sudden cardiac arrest in sleep. months).

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A 50-something man with Chest pain at triage

Dr. Smith's ECG Blog

Unexplained cardiac arrest or documented VF/polymorphic VT: +3 3. Unexplained sudden cardiac death (3 categories) (+0.5 - +2) 4. Cardiac arrest. Clinical History 2.a. of atrial fib/flutter at age less than 30: +0.5 syncope of unclear etiology: +1 2.c. Suspected arrhythmic syncope: +2 2.d.