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JAMA study provides clues to cause of sudden cardiac death in teens

Fainting during childhood, and whether a teen is going through the male or female changes of puberty, are among the factors that predict whether a genetic defect will suddenly stop the teen's heartbeat, according to a study published today in the Journal of the American Medical Association (JAMA). The study also found that treating teens at the highest risk for fatal arrhythmias with widely used blood pressure drugs reduced their risk by 64 percent.

Cardiac arrhythmias are electrical malfunctions that throw the heart out of rhythm, causing many of the 330,000 sudden cardiac deaths each year in the United States. Most fatal arrhythmias occur in aging patients when scar tissue left by a heart attack interferes with the heart's electrical system. As many as 1,000 of the deaths, however, are caused by a genetic disorder called Long QT Syndrome (LQTS), which occurs mostly in teens with otherwise healthy hearts.

The QT interval is part of the heart's electrical signature as recorded by an electrocardiogram (ECG). It represents the time it takes for the heart's lower chambers to "reset" electrically after each heartbeat. In LQTS patients, the QT reset time is prolonged, which makes the heart more susceptible to fatal arrhythmias. The condition may go unnoticed until sports, strong emotions or even loud noises knock the heart out of rhythm, causing loss of pulse and consciousness (syncope). Sudden death often results if the heart is not restarted with a defibrillator.

"LQTS shocks communities across the nation each year as teens die during sporting events," said Arthur Moss, M.D., professor of Medicine in the Department of Medicine at the University of Rochester Medical Center and an author of the JAMA paper. "It runs in families and can remain undiagnosed until the victim's brother or sister dies as well. New research has made clear the factors that accurately predict which kids are at high risk, factors that can be easily be monitored duri
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Contact: Greg Williams
Greg_Williams@urmc.rochester.edu
585-273-1757
University of Rochester Medical Center
12-Sep-2006


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