Out-of-hospital pediatric sudden cardiac arrest and inherited arrhythmia syndromes in Hungary.

Abstract

The incidence of pediatric out-of-hospital sudden cardiac arrest is low, but a part of them could be preventable. Aim of our study was to assess the pediatric cardiac arrest in Hungary and the magnitude of inherited cardiac arrhythmias in the background. Three methods were used. 1) Utstein data sheets of the National Ambulance Service between 01. 01. 2012 and 30. 06. 2015. 2) Records of admissions to the national tertiary pediatric heart centre, due to out-of-hospital pediatric sudden cardiac arrest between 01. 01. 2000 - 11. 08. 2021. and 3) Results of genetic testing in patients with suspicion of inherited arrhythmia syndromes between 01. 10. 2015 - 11. 08. 2021 were analysed retrospectively. 1) Ambulance was called to 373 paediatric cardiac arrests during the study period of 3.5 years. Primary cardiac origin was presumed in 84 cases (≈24/year) on the basis of Utstein data sheets. Reanimation was successful in 20%. 2) 24 children (≈1/year) were admitted to the national pediatric heart centre after out-of-hospital sudden cardiac arrest during the study period of 21 years. Inherited arrhythmia syndromes in 11/24 (46%), structural heart disease in 4/24 (16%) cases could be identified, but etiology remained unclear in the rest 9/24 (38%). 3) Suspicion of inherited arrhythmia syndrome emerged in 73 children in 6 years of the study (≈12/year) and it was based on pathological ECG: n = 23, family screening: n = 21, syncope: n = 15, successful reanimation: n = 14. Genetic testing revealed pathological variation in 29 cases (≈5/year), variant of unknown significance in 15 cases. 20-25 children have out-of-hospital cardiac arrest annually in Hungary based on data from the National Ambulance Service. Reanimation is successful in one fifth of the cases. One fifth of these surviving children had no severe complications and neurological deficit and they were admitted to the national pediatric heart centre for further diagnosis and treatment (5% of pediatric cardiac arrest). Inherited arrhythmia syndrome could be identified in the background in half of these admissions. One fifth of children checked up and followed for inherited arrhythmia syndrome in the national centre were diagnosed after sudden cardiac arrest. Orv Hetil. 2022; 163(12): 473-477.