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Sudden arrhythmic death syndrome: a national survey of sudden unexplained cardiac death
  1. E R Behr1,
  2. A Casey2,
  3. M Sheppard2,
  4. M Wright2,
  5. T J Bowker2,
  6. M J Davies1,*,
  7. W J McKenna3,
  8. D A Wood2
  1. 1Cardiological Sciences, St George’s University of London, London, UK
  2. 2Clinical Epidemiology and Pathology, National Heart & Lung Institute at Royal Brompton & Harefield Campus, Imperial College, University of London, London, UK
  3. 3The Heart Hospital, University College Hospital, London, UK
  1. Correspondence to:
    Professor D A Wood
    Clinical Epidemiology and Pathology, National Heart & Lung Institute at Royal Brompton & Harefield Campus, Imperial College, University of London, London W6 8RF, UK;d.wood{at}


Objective: To describe the characteristics of sudden arrhythmic death syndrome (SADS) and compare its incidence with official national mortality statistics for unascertained deaths.

Design and setting: Sudden unexplained deaths were prospectively surveyed through 117 coroners’ jurisdictions in England. Consecutive cases meeting the following criteria were included: white Caucasian, aged 4–64 years, no history of cardiac disease, last seen alive within 12 h of death, normal coroner’s autopsy, cardiac pathologist’s confirmation of a normal heart and negative toxicology.

Main outcome measures: The estimated mortality from SADS was calculated and the official mortality statistics for unascertained causes of deaths in 4–64-year-olds was identified for the same time period.

Results: 115 coroner’s cases were reported and 56 (49%) SADS victims were identified: mean age 32 years, range 7–64 years and 35 (63%) male. 7 of 39 cases (18%) had a family history of other premature sudden deaths (<45). The estimated mortality from SADS was 0.16/100 000 per annum (95% CI 0.12 to 0.21), compared with an official mortality of 0.10/100 000 per annum for International Classification of Diseases 798.1 (sudden death, cause unknown—instantaneous death) or 1.34/100 000 per annum for unascertained causes of death.

Conclusions: Deaths from SADS occur predominantly in young males. When compared with official mortality, the incidence of SADS may be up to eight times higher than estimated: more than 500 potential SADS cases per annum in England. Families with SADS carry genetic cardiac disease, placing them at risk of further sudden deaths. SADS should therefore be a certifiable cause of death prompting specialised cardiological evaluation of families.

  • ICD, International Classification of Diseases
  • LREC, local research ethics committee
  • ONS, Office of National Statistics
  • SADS, sudden arrhythmic death syndrome

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  • * Posthumously.

  • Published Online First 18 January 2007

  • Funding: This study was supported by British Heart Foundation grants (PG/96039).

  • Competing interests: None.

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