Faculty Collaboration Database

Circadian variation in sudden cardiac death: effects of age, sex, and initial cardiac rhythm. Ann Emerg Med 1996 Jan;27(1):29-34

Date

01/01/1996

Pubmed ID

8572444

DOI

10.1016/s0196-0644(96)70292-5

Scopus ID

2-s2.0-0030065536 (requires institutional sign-in at Scopus site)   50 Citations

Abstract

STUDY OBJECTIVE: Previous studies based on data obtained from vital statistics records have demonstrated circadian variation in the occurrence of sudden cardiac death. The purpose of this study was to examine the effects of age, sex, and initial cardiac rhythm on circadian variability in sudden cardiac death.

METHODS: This study employed a retrospective analysis of the records of adult patients with witnessed cardiac arrest who underwent resuscitation in an urban paramedic system during a 5-year period.

RESULTS: The records of 2,250 consecutive patients with witnessed cardiac arrest were reviewed. Spectral analysis was used to decompose the data into frequency components. A circadian variation in the occurrence of sudden cardiac death was demonstrated, with a low occurrence rate between midnight and 6 AM and a 2.4-fold increase between the rate at 6 AM and the rate at noon. The same circadian pattern was noted among both men and women, among both patients aged 18 to 70 and those older than 70 years, and among patients with various initial cardiac arrest rhythms (ventricular tachycardia or fibrillation, asystole, and electromechanical dissociation). However, the outcome of resuscitation in these patients (ie, the rate of successful resuscitation and the rate of survival) did not demonstrate circadian variation.

CONCLUSION: Witnessed out-of-hospital sudden cardiac death demonstrated circadian variation, and this variability was observed regardless of the patient's age, sex, or initial cardiac arrest rhythm. The outcome of resuscitation did not show circadian variability. These results suggest a common pathophysiologic mechanism leading to sudden cardiac death.

Author List

Thakur RK, Hoffmann RG, Olson DW, Joshi R, Tresch DD, Aufderheide TP, Ip JH

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Distribution
Aged
Arrhythmias, Cardiac
Circadian Rhythm
Death, Sudden, Cardiac
Emergency Medical Services
Female
Humans
Male
Middle Aged
Resuscitation
Retrospective Studies
Sex Distribution
Survival Analysis
Time Factors
Treatment Outcome