For a study, researchers sought to determine the prevalence of Sudden cardiac arrest (SCA) and its causes and effects. A retrospective investigation of all pediatric heart transplant (HT) patients treated at the facility between January 1, 2009, and January 1, 2021 (inclusive). A sudden loss of cardiac function that required cardiopulmonary resuscitation and mechanical circulatory support (MCS) was an SCA case. Events that took place while the patient was on MCS or while they had limited resuscitative wishes were not included in the analysis. The features of the patients, as well as the risk variables, were evaluated. At a median of 3 (1, 4) years after HT, 14 out of 254 patients suffered SCA. This is a 6% incidence rate. About 7 of the events, or 50%, took place outside of the hospital. Around 11 of them, or 79%, passed away as a direct result of the initial incident, and 2 of them, or 18%, died as a result of their inability to separate from the extracorporeal membrane (ECMO) successfully. In univariate analysis, factors that were associated with sudden cardiac arrest included being black, having a younger donor age, having a history of acute cellular rejection (ACR), having a pacemaker and an implantable cardioverter defibrillator (ICD), and having a premortem diagnosis of allograft vasculopathy (P=.003-0.02). After taking into account several variables, the history of ACR, younger donor age, and black race all remained significant. [OR = 6.3, 95% CI: 1.6-25.4, P=.01], [OR = 0.9, 95% CI: 0.8-1, P=.04], and [OR = 7.3, 95% CI: 1.1-49.9, P=.04]  are the respective odds ratios. SCA happened in 3 individuals who were already fitted with a pacemaker or an ICD; however, these devices could not restore a perfusing rhythm. SCA developed at a relatively early stage following HT in children and was almost always deadly. The home was where half the action takes place. Those at greater risk include those who received organs from younger donors, had a previous history of ACR, or were of the black race. ICDs and pacemakers might provide some level of protection.

Source – sciencedirect.com/science/article/abs/pii/S0002870322001272