Journal of Pediatric Cardiology and Cardiac Surgery

Background: Hypertrophic cardiomyopathy (HCM) is a major cause of sudden death in children in the school setting; however, more students with HCM are being successfully resuscitated due to the increased spread and accessibility of basic life support systems. Therefore, the prognosis for students with HCM who experience cardiac events at school is in a transitional period whereby the chances of survival are gradually improving. The present study aimed to determine the outcomes of cardiac events arising in children with HCM and the effects of automated external defibrillators (AED) applied under school supervision.

Methods: We retrospectively studied case reports of cardiac events occurring in schoolchildren with HCM submitted to the Mutual Aid System in Japan between 2004 and 2011.

Results: Among 44 children with HCM who experienced sudden cardiac events at school, 29 died and 15 survived following resuscitation. An AED was applied to 14 of the survivors and one individual already had an implantable cardioverter defibrillator (ICD) surgically inserted. There was a prevalence of males in both the survivor and non-survivor groups. Among children with HCM who experienced cardiac events in kindergarten, primary school, junior high school (JHS) and high school (HS), only those in the latter two levels of education tended to recover from cardiac events. The ratios (%) of victims and survivors that had been pre-diagnosed with HCM prior to the onset of cardiac events in the JHS and HS groups were 48% and 20%, respectively. Cardiac events occurred most frequently during exercise in both the survivor and non-survivor groups.

Conclusions: The numbers of individuals diagnosed with HCM who are successfully resuscitated after cardiac arrest while under school supervision has significantly improved in Japan since 2007. This can be attributed to the growing availability of AEDs and ICDs—both of which are essential solutions to prevent sudden cardiac death due to HCM in schoolchildren.