Department of Cardiology, Sørlandet Hospital, PO Box 783, Stoa, 4809 Arendal, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Research Department, Sørlandet Hospital, Kristiansand, Norway.
Eur Heart J. 2016 Feb 14;37(7):621-6. doi: 10.1093/eurheartj/ehv478. Epub 2015 Sep 4.
Congenital heart defects (CHDs) are the most common birth defects and are an important cause of death in children. The fear of sudden unexpected death has led to restrictions of physical activity and competitive sports. The aim of the present study was to investigate the rate of sudden unexpected deaths unrelated to surgery in children 2-18 years old with CHDs and, secondarily, to determine whether these deaths were related to cardiac disease, comorbidity, or physical activity.
To identify children with CHDs and to determine the number of deaths, data concerning all 9 43 871 live births in Norway in 1994-2009 were retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry for Congenital Heart Defects and the Norwegian Cause of Death Registry. Survivors were followed through 2012, and information for the deceased children was retrieved from medical records at Norwegian hospitals. Among 11 272 children with CHDs, we identified 19 (0.2%) children 2-18 years old who experienced sudden unexpected deaths unrelated to cardiac surgery. A cardiac cause of death was identified in seven of these cases. None of the children died during physical activity, whereas two children survived cardiac arrest during sports.
Sudden unexpected death was infrequent among children with CHDs who survived 2 years of age. Comorbidity was common among the children who died. This study indicates that sudden unexpected death in children with CHDs rarely occurs during physical activity.
先天性心脏病（CHD）是最常见的出生缺陷，也是儿童死亡的重要原因。对猝死的恐惧导致了对体力活动和竞技体育的限制。本研究的目的是调查 2-18 岁患有 CHD 的儿童中与手术无关的猝死发生率，其次是确定这些死亡是否与心脏病、合并症或体力活动有关。
为了确定患有 CHD 的儿童并确定死亡人数，从挪威医学出生登记处、挪威心血管疾病项目、奥斯陆大学医院先天性心脏病临床登记处和挪威死因登记处检索了 1994-2009 年所有 943871 例活产的数据。幸存者随访至 2012 年，从挪威医院的病历中检索了已故儿童的信息。在 11272 名患有 CHD 的儿童中，我们确定了 19 名（0.2%）2-18 岁的儿童经历了与心脏手术无关的猝死。在这些病例中，有 7 例确定为心脏原因死亡。没有儿童在体力活动中死亡，而有 2 名儿童在运动中心脏骤停后幸存。
在存活 2 年以上的 CHD 儿童中，猝死很少见。死亡儿童中合并症很常见。本研究表明，CHD 儿童很少在体力活动中发生猝死。
