Unexpected shift in circadian and septadian variation of sudden cardiac arrest: the Oregon Sudden Unexpected Death Study

Yu Ming Ni, Carmen Rusinaru, Kyndaron Reinier, Audrey Uy-Evanado, Harpriya Chugh, Eric Stecker, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Earlier studies have reported both early morning and Monday peaks in occurrence of sudden cardiac arrest (SCA) in the community and appropriate defibrillator shocks in patients with an implantable cardioverter–defibrillator (ICD). However, a more recent analysis of ICD shocks reported absence of these peaks. Objective: The purpose of this study was to perform a contemporary evaluation of the circadian and septadian variation of SCA in the general population. Methods: The analysis was performed from an ongoing, population-based study of SCA in a Northwestern US community of approximately 1 million residents. To maximize accuracy, we focused on consecutive patients who presented with witnessed SCA and were attended by emergency medical services (EMS). The specific time of each SCA event was determined based on the time of the 911 call to EMS. Results: During 2002–2014, we identified 1535 patients age ≥18 years who suffered witnessed SCA, with time of first EMS contact recorded. There was no morning (6 AM to 12 PM) peak, and we observed a nadir in SCA events during 12 AM to 6 AM, with only 13.9% of events occurring during this 6-hour block (P <.0001). There was no peak on Mondays, but a nadir was observed on Sundays that accounted for only 11.3% of SCA events during the week (P = .004). Conclusion: in this contemporary community-based study, we failed to observe the expected morning peak or the Monday peak in SCA, duplicating recent findings in primary prevention defibrillator patients. The significant public health implications of these findings merit further investigation.

Original languageEnglish (US)
JournalHeart Rhythm
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Sudden Cardiac Death
Sudden Death
Emergency Medical Services
Defibrillators
Shock
Primary Prevention
Population
Public Health

Keywords

  • Circadian
  • Diurnal
  • Epidemiology
  • Population
  • Septadian
  • Sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Unexpected shift in circadian and septadian variation of sudden cardiac arrest : the Oregon Sudden Unexpected Death Study. / Ni, Yu Ming; Rusinaru, Carmen; Reinier, Kyndaron; Uy-Evanado, Audrey; Chugh, Harpriya; Stecker, Eric; Jui, Jonathan; Chugh, Sumeet S.

In: Heart Rhythm, 01.01.2018.

Research output: Contribution to journalArticle

Ni, Yu Ming ; Rusinaru, Carmen ; Reinier, Kyndaron ; Uy-Evanado, Audrey ; Chugh, Harpriya ; Stecker, Eric ; Jui, Jonathan ; Chugh, Sumeet S. / Unexpected shift in circadian and septadian variation of sudden cardiac arrest : the Oregon Sudden Unexpected Death Study. In: Heart Rhythm. 2018.
@article{57c4cefbfdee42f0a375b3b1a078b5da,
title = "Unexpected shift in circadian and septadian variation of sudden cardiac arrest: the Oregon Sudden Unexpected Death Study",
abstract = "Background: Earlier studies have reported both early morning and Monday peaks in occurrence of sudden cardiac arrest (SCA) in the community and appropriate defibrillator shocks in patients with an implantable cardioverter–defibrillator (ICD). However, a more recent analysis of ICD shocks reported absence of these peaks. Objective: The purpose of this study was to perform a contemporary evaluation of the circadian and septadian variation of SCA in the general population. Methods: The analysis was performed from an ongoing, population-based study of SCA in a Northwestern US community of approximately 1 million residents. To maximize accuracy, we focused on consecutive patients who presented with witnessed SCA and were attended by emergency medical services (EMS). The specific time of each SCA event was determined based on the time of the 911 call to EMS. Results: During 2002–2014, we identified 1535 patients age ≥18 years who suffered witnessed SCA, with time of first EMS contact recorded. There was no morning (6 AM to 12 PM) peak, and we observed a nadir in SCA events during 12 AM to 6 AM, with only 13.9{\%} of events occurring during this 6-hour block (P <.0001). There was no peak on Mondays, but a nadir was observed on Sundays that accounted for only 11.3{\%} of SCA events during the week (P = .004). Conclusion: in this contemporary community-based study, we failed to observe the expected morning peak or the Monday peak in SCA, duplicating recent findings in primary prevention defibrillator patients. The significant public health implications of these findings merit further investigation.",
keywords = "Circadian, Diurnal, Epidemiology, Population, Septadian, Sudden cardiac death",
author = "Ni, {Yu Ming} and Carmen Rusinaru and Kyndaron Reinier and Audrey Uy-Evanado and Harpriya Chugh and Eric Stecker and Jonathan Jui and Chugh, {Sumeet S.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.hrthm.2018.08.034",
language = "English (US)",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",

}

TY - JOUR

T1 - Unexpected shift in circadian and septadian variation of sudden cardiac arrest

T2 - the Oregon Sudden Unexpected Death Study

AU - Ni, Yu Ming

AU - Rusinaru, Carmen

AU - Reinier, Kyndaron

AU - Uy-Evanado, Audrey

AU - Chugh, Harpriya

AU - Stecker, Eric

AU - Jui, Jonathan

AU - Chugh, Sumeet S.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Earlier studies have reported both early morning and Monday peaks in occurrence of sudden cardiac arrest (SCA) in the community and appropriate defibrillator shocks in patients with an implantable cardioverter–defibrillator (ICD). However, a more recent analysis of ICD shocks reported absence of these peaks. Objective: The purpose of this study was to perform a contemporary evaluation of the circadian and septadian variation of SCA in the general population. Methods: The analysis was performed from an ongoing, population-based study of SCA in a Northwestern US community of approximately 1 million residents. To maximize accuracy, we focused on consecutive patients who presented with witnessed SCA and were attended by emergency medical services (EMS). The specific time of each SCA event was determined based on the time of the 911 call to EMS. Results: During 2002–2014, we identified 1535 patients age ≥18 years who suffered witnessed SCA, with time of first EMS contact recorded. There was no morning (6 AM to 12 PM) peak, and we observed a nadir in SCA events during 12 AM to 6 AM, with only 13.9% of events occurring during this 6-hour block (P <.0001). There was no peak on Mondays, but a nadir was observed on Sundays that accounted for only 11.3% of SCA events during the week (P = .004). Conclusion: in this contemporary community-based study, we failed to observe the expected morning peak or the Monday peak in SCA, duplicating recent findings in primary prevention defibrillator patients. The significant public health implications of these findings merit further investigation.

AB - Background: Earlier studies have reported both early morning and Monday peaks in occurrence of sudden cardiac arrest (SCA) in the community and appropriate defibrillator shocks in patients with an implantable cardioverter–defibrillator (ICD). However, a more recent analysis of ICD shocks reported absence of these peaks. Objective: The purpose of this study was to perform a contemporary evaluation of the circadian and septadian variation of SCA in the general population. Methods: The analysis was performed from an ongoing, population-based study of SCA in a Northwestern US community of approximately 1 million residents. To maximize accuracy, we focused on consecutive patients who presented with witnessed SCA and were attended by emergency medical services (EMS). The specific time of each SCA event was determined based on the time of the 911 call to EMS. Results: During 2002–2014, we identified 1535 patients age ≥18 years who suffered witnessed SCA, with time of first EMS contact recorded. There was no morning (6 AM to 12 PM) peak, and we observed a nadir in SCA events during 12 AM to 6 AM, with only 13.9% of events occurring during this 6-hour block (P <.0001). There was no peak on Mondays, but a nadir was observed on Sundays that accounted for only 11.3% of SCA events during the week (P = .004). Conclusion: in this contemporary community-based study, we failed to observe the expected morning peak or the Monday peak in SCA, duplicating recent findings in primary prevention defibrillator patients. The significant public health implications of these findings merit further investigation.

KW - Circadian

KW - Diurnal

KW - Epidemiology

KW - Population

KW - Septadian

KW - Sudden cardiac death

UR - http://www.scopus.com/inward/record.url?scp=85053889812&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053889812&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2018.08.034

DO - 10.1016/j.hrthm.2018.08.034

M3 - Article

C2 - 30193852

AN - SCOPUS:85053889812

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

ER -