Arrhythmias & electrophysiology

Sudden Cardiac Death and its Relation to Previously Diagnosed or Occult Cardiac Disease at Autopsy

J Am Coll CardiolPublished Prospective cohort study

Authors' conclusion

In this 12-year countywide postmortem study, two-thirds of community arrhythmic SCDs occurred in individuals without diagnosed disease despite substantial cardiac pathology; half of these "silent" arrhythmic deaths had occult MI or DCM.

Study context

Population
Presumed sudden cardiac death (SCDs) meeting WHO criteria in a countywide community (POST SCD)513 arrhythmic deaths
Participants
877 participants
Exposure
Arrhythmic SCDs with diagnosed RFs vs occult myocardial infarction (MI) or dilated cardiomyopathy (DCM) vs neither; trauma deaths as reference
  • Diagnosed RFsn = 166
  • Occult MI or DCMn = 159
  • Remaining arrhythmic deathsn = 185
Outcome
Sensitivity (prevalence) of diagnosed RFs for autopsy-defined arrhythmic death
Methodological detailscountywide, autopsy-based, 12-year
  • Countywide
  • Autopsy-based
  • 12-year

Main finding

As reported in the abstract

Distribution of autopsy-defined arrhythmic deaths
OutcomeDiagnosed RFsOccult MI or DCMRemaining arrhythmic deaths
Distribution of autopsy-defined arrhythmic deaths32%31%36%
Mean age64.3 years62.6 years56.9 years
Men77%80%— not stated in the abstract

— not stated in the abstract

Sensitivity of diagnosed RFs for arrhythmic death
32%
Autopsy-defined arrhythmic deaths among presumed SCDs
513 (58%)

Observational data: associations, not effects.

Further findings

OutcomeP value
Cardiac pathology: remaining arrhythmic deaths vs trauma deathsRemaining arrhythmic deaths vs Trauma deaths · heart weight Z-score 0.9 vs 0.0P < 0.001
Cardiac pathology: remaining arrhythmic deaths vs trauma deathsRemaining arrhythmic deaths vs Trauma deaths · LV diameter 2.5 cm vs 1.9 cmP < 0.001
Cardiac pathology: remaining arrhythmic deaths vs trauma deathsRemaining arrhythmic deaths vs Trauma deaths · significant coronary disease 52% vs 13%P < 0.001
Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Similar fibrosis
6.7% vs 6.3%
Cardiac pathology: remaining arrhythmic deaths vs trauma deaths — Similar LV hypertrophy burden
57% vs 55%
  • Cardiac pathology: remaining arrhythmic deaths vs trauma deaths: all P < 0.001

Original publication

Sudden Cardiac Death and its Relation to Previously Diagnosed or Occult Cardiac Disease at Autopsy. J Am Coll Cardiol. Published 23 April 2026. doi:10.1016/j.jacc.2026.01.029

Composed by AI from the published abstract and checked against it. How Briefs are made →

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