Sudden cardiac arrest in nonischemic heart disease. Role of medication, substance abuse and initial rhythm
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital Auditorium 10
Topic of the dissertation
Sudden cardiac arrest in nonischemic heart disease. Role of medication, substance abuse and initial rhythm
Doctoral candidate
Doctor of Medicine Janna Kauppila
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Internal Medicine
Subject of study
Medicine
Opponent
Professor Antti Saraste, Turku University Hospital and University of Turku
Custos
Professor Juhani Junttila, Oulu University Hospital and University of Oulu
Sudden cardiac arrest in nonischemic heart disease. Role of medication, substance abuse and initial rhythm
During sudden cardiac arrest (SCA), the heart suddenly and unexpectedly stops beating. It usually leads to sudden cardiac death (SCD), which is the most common mode of death in Western countries. Nonischemic heart disease (NIHD) causes about 20% of SCAs. Many factors, such as medication or substance abuse, can induce SCA in patients with heart disease. The aim of this thesis was to investigate the role of psychotropics, alcohol and initial rhythm in nonischemic SCA.
Studies I and II compared the initial rhythms of SCA subjects with attempted resuscitation by the emergency personnel. In study I, non-shockable initial rhythm was associated with underlying NIHD. In study II, use of psychotropic medication was associated with non-shockable initial rhythm.
Studies III and IV were based solely on the Fingesture population, which consists of 5,869 consecutive victims of SCD in Northern Finland during 1998–2017. In study III, 42% of victims with NIHD had alcohol in blood at the time of death. Elevated blood alcohol level was more common in men than in women. In study IV, we reported use of psychotropic medication in 41% of subjects with NIHD. According to Finnish Statistics on Medicines 2018, only 12% of the general Finnish population are users of psychotropic medication.
The cause of death was determined by medico-legal autopsy in all cases, and the cause of SCA in the survivors in studies I and II was assessed by a clinical examination including echocardiography and coronary angiography. Overall, we consider the results of these studies to improve the as yet poor understanding of the causes and mechanisms of SCA.
Studies I and II compared the initial rhythms of SCA subjects with attempted resuscitation by the emergency personnel. In study I, non-shockable initial rhythm was associated with underlying NIHD. In study II, use of psychotropic medication was associated with non-shockable initial rhythm.
Studies III and IV were based solely on the Fingesture population, which consists of 5,869 consecutive victims of SCD in Northern Finland during 1998–2017. In study III, 42% of victims with NIHD had alcohol in blood at the time of death. Elevated blood alcohol level was more common in men than in women. In study IV, we reported use of psychotropic medication in 41% of subjects with NIHD. According to Finnish Statistics on Medicines 2018, only 12% of the general Finnish population are users of psychotropic medication.
The cause of death was determined by medico-legal autopsy in all cases, and the cause of SCA in the survivors in studies I and II was assessed by a clinical examination including echocardiography and coronary angiography. Overall, we consider the results of these studies to improve the as yet poor understanding of the causes and mechanisms of SCA.
Last updated: 23.1.2024