Syncope, Seizure May Precede Cardiac Arrest in Children, Young Adults

The survey had a small sample size, Dr. Drezner acknowledged. "But this is a difficult population to identify in terms of families who are willing to participate and also just children who have had cardiac arrest."

In addition, the study would have benefited from having a control group of children who had syncope or seizures, but did not go on to experience SCA, he said.

"My message that was really reinforced from this study is that syncope is not benign," Dr. Drezner said. Fainting usually does have a vasovagal etiology, he added. But "vasovagal [syncope] is a diagnosis of exclusion. ... Everyone deserves at least one ECG."

Besides lack of awareness, providers may have other reasons for not obtaining an ECG in this context, he noted. For example, "they are worried they will miss something, they are not sure how to interpret it."

And some may be concerned about false-positive results that could lead to unnecessary workups. But his team’s experience in performing screenings in high schools, using contemporary criteria for ECG interpretation, is that even the total positive rate is less than 2%.

"Prior studies show a higher false-positive rate, but those prior studies really came before we understood better how to interpret an ECG in that setting," he explained.

Dr. Drezner reported that he had no relevant financial disclosures.