Tseng Andrew S, Sardana Mayank, Giudicessi John R, Ackerman Michael J
Department of Cardiovascular Medicine, Division of Heart Rhythm Services and Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Jacksonville, FL, USA.
Department of Cardiovascular Medicine, Division of Heart Rhythm Services and Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Phoenix, AZ, USA.
Trends Cardiovasc Med. 2025 Apr;35(3):177-183. doi: 10.1016/j.tcm.2024.11.002. Epub 2024 Nov 20.
Unexplained sudden cardiac arrest (SCA) and sudden cardiac death (SCD) in the young remains a critical issue for clinicians, researchers, patients and their family members. In this review, we explore the current status of SCA and SCD evaluation in the young, including recent monogenic and polygenic disease discoveries, advancements in cardiac imaging and our growing understanding of the role of the Purkinje system in triggering life threatening and even fatal ventricular arrhythmias. Yet, despite these advancements, over a third of SCA and SCD among individuals with seemingly structurally normal hearts remain unexplained. We explore the future role of artificial intelligence, novel biomarkers, multimodality cardiac imaging, genetic discoveries, as well as wearable devices and sensors in closing this current gap. With the overarching framework provided in this review, we envision a future in which collaboration among patients, clinicians, researchers, innovators, and policy makers culminates in our ability to diagnose, predict, and ultimately prevent SCA and SCD in the young.
年轻人不明原因的心源性猝死（SCA）和心脏性猝死（SCD）仍然是临床医生、研究人员、患者及其家属面临的关键问题。在这篇综述中，我们探讨了年轻人SCA和SCD评估的现状，包括近期单基因和多基因疾病的发现、心脏成像技术的进展以及我们对浦肯野系统在引发危及生命甚至致命性室性心律失常中作用的日益深入理解。然而，尽管有这些进展，在心脏结构看似正常的个体中，仍有超过三分之一的SCA和SCD病例原因不明。我们探讨了人工智能、新型生物标志物、多模态心脏成像、基因发现以及可穿戴设备和传感器在弥补当前差距方面的未来作用。基于本综述提供的总体框架，我们设想未来患者、临床医生、研究人员、创新者和政策制定者之间的合作将最终使我们有能力诊断、预测并最终预防年轻人的SCA和SCD。
