Abstract 12857: Electrocardiographic Findings in Women With Ischemic Sudden Cardiac Death and Anatomic Left Ventricular Hypertrophy

Abstract

Background: Sudden cardiac death (SCD) is a major mode of death worldwide. Previous SCD studies have shown that left ventricular hypertrophy (LVH) is a risk factor for SCD, especially in the presence of myocardial scarring or ischemia. Due to the lower incidence, women are often underrepresented in SCD studies and therefore, most recognized SCD risk factors are biased towards men. Aim: The aim of this study was to investigate sex-specific ECG findings in subjects with ischemic SCD and LVH. Methods: The study population was derived from the FinGesture study, which has collected all SCD cases from Northern Finland 1998-2017. All SCD cases underwent medicolegal autopsy to determine the cause of death. In the present study, we selected SCD cases with coronary artery disease (CAD) and anatomic LVH at autopsy, of whom antemortem electrocardiogram (ECG) was available for 483 subjects (24.4 % women; 75.6 % men). Antemortem recorded ECGs were obtained from medical records and independently analyzed by two investigators. Results: The prevalence of pathological Q-waves (11.9 % vs. 22.1 %, p = 0.016) and fragmented QRS (fQRS) (43.9 % vs. 56.4 %, p = 0.033) was lower in women compared to men. In addition, women were less likely to have prolonged QTc duration (17.8 % in women vs. 32.3 % in men, p = 0.003). The only ECG finding that appeared as more prevalent in women with anatomic LVH was ECG-LVH by Cornell’s criteria (26.4 % vs. 12.4 %, p = 0.002). The prevalence of having abnormal ECG was slightly lower in women (82.2 %) compared to men (89.2 %), p = 0.054. There were no significant differences between sexes when comparing the prevalence of anatomic LVH in subjects with ECG-LVH and ischemic SCD (90.6 % in women vs. 84.9 % in men, p = 0.524). Conclusions: Except for ECG-LVH by Cornell’s criteria, women with ischemic SCD and anatomic LVH were less likely than men to have ECG findings that are often associated with an increased risk of SCD.