Out-of-hospital cardiac arrest—the relevance of heart failure. The Maastricht Circulatory Arrest Registry

Aims To describe the incidence and aetiology of heart failure in out-of-hospital sudden circulatory arrest (SCA) in the Maastricht area of the Netherlands. Methods All cases of SCA were studied in the age group 20 to 75 years between 1 January 1997 and 31 December 2000. Demographic characteristics, aetiology and clinical features, related to heart failure were studied. Results Four hundred and ninety-two patients were included (72 % men), mean age of 62±10. The yearly incidence of SCA was 9.2/10 000 inhabitants. Sudden death repre-sented 19 % of all deaths, occurring in the same time period. In 52 % of the men and 59% of women, SCA was the first manifestation of heart disease. In the SCA group with a cardiac history overt heart failure was present in 26 % of the cases, the time interval between the first heart failure episode and SCA being 4.3±6.3 year. In the heart failure group the majority had previously been in a poor functional class and LVEF. Concern-ing aetiology, of the SCA group, 77 % were known with CAD and 72 % with an old MI. Also in the group with a LVEF>50 % CAD was the most frequent cause. Conclusions There is an increased risk of SCA at poorer pump function and most SCA victims with previous heart failure are in a poor functional class SCA. However heart failure is seen in only a minority of the SCA population. CAD is by far the most common cause of SCA