Sudden cardiac arrest (SCA) is a critical medical emergency characterized by the abrupt loss of heart function, typically caused by ventricular fibrillation or pulseless ventricular tachycardia. It remains a leading cause of death worldwide, accounting for more than 300,000 deaths annually in the United States alone (1). SCA often occurs without warning and in individuals without a known history of heart disease, making early detection and intervention challenging yet crucial for survival.

The survival rate of out-of-hospital cardiac arrest is alarmingly low, generally less than 10%, emphasizing the need for preventive strategies rather than reactive interventions (2). Most cases of SCA are linked to underlying structural heart disease or electrical abnormalities, such as hypertrophic cardiomyopathy, long QT syndrome, or ischemic heart disease, which may be detectable through non-invasive diagnostic methods (3). Electrocardiography (ECG), echocardiography, cardiac biomarkers, and risk scoring systems such as the Framingham Risk Score are valuable tools for identifying individuals at elevated risk of SCA (4).

Timely identification of at-risk individuals allows for the implementation of targeted preventive measures, including lifestyle modifications, pharmacotherapy, and in some cases, implantable cardioverter-defibrillators (ICDs), all of which have been shown to significantly improve outcomes (5). This study aims to evaluate the effectiveness of early screening and diagnostic methods in identifying at-risk individuals and reducing the incidence of SCA-related mortality through timely intervention.

A prospective observational study was conducted over a period of six months to evaluate the effectiveness of early screening and diagnosis in preventing sudden cardiac arrest (SCA). The study included 100 adult participants aged between 20 and 60 years, who either presented with symptoms suggestive of cardiac issues (such as palpitations, chest discomfort, or syncope) or had a family history of cardiovascular diseases. All participants were recruited from outpatient departments of general medicine and cardiology at a tertiary care hospital.

Inclusion criteria involved adults with at least one cardiovascular risk factor (hypertension, diabetes mellitus, smoking, dyslipidemia, or positive family history of SCA) or symptoms indicating potential cardiac pathology. Patients with a known diagnosis of structural heart disease or those already on cardiac medications for arrhythmias were excluded from the study.

Upon enrollment, all participants underwent a structured evaluation, which included a detailed clinical history, physical examination, and baseline investigations. The screening protocol consisted of 12-lead electrocardiography (ECG), transthoracic echocardiography (TTE), and measurement of cardiac biomarkers including high-sensitivity troponin-I. Risk assessment was also performed using the Framingham Risk Score (FRS), which estimates the 10-year cardiovascular risk based on age, sex, lipid profile, blood pressure, smoking status, and presence of diabetes.

Participants identified as high-risk based on any abnormality in the above investigations were referred for further cardiology evaluation. Interventions such as lifestyle counseling, pharmacological therapy, or recommendation for implantable cardioverter-defibrillator (ICD) placement were offered as per the cardiologist’s discretion.

All participants were followed up monthly for a minimum of three months to monitor for cardiac events, including arrhythmias or sudden cardiac arrest, and assess compliance with recommended preventive strategies. Data were recorded and statistically analyzed using descriptive statistics and chi-square tests to determine the association between early diagnosis and reduction in SCA incidence. A p-value < 0.05 was considered statistically significant.

Out of the 100 participants screened, 58 were male and 42 were female. The mean age of the participants was 44.2 ± 10.6 years. Based on the initial clinical and diagnostic evaluation, a significant number of participants exhibited abnormalities suggestive of elevated cardiovascular risk.

A total of 24 participants (24%) showed ECG abnormalities, such as prolonged QT interval, T wave inversion, or signs of ventricular hypertrophy. Echocardiographic evaluation revealed left ventricular hypertrophy or reduced ejection fraction (<50%) in 18 participants (18%). Elevated serum troponin-I levels (>0.04 ng/mL) were observed in 12 participants (12%), indicating possible silent myocardial ischemia (Table 1).

Table 1. Diagnostic Findings Among Study Participants

Thirty participants (30%) were classified as high-risk based on either diagnostic findings or Framingham Risk Score. These individuals were subjected to further cardiology evaluation. Among them, 18 participants (60%) were managed with lifestyle changes and medication, while 10 (33%) required pharmacotherapy alone. ICD implantation was advised and accepted in 2 participants (7%) based on clinical criteria (Table 2).

Table 2. Management and Outcomes of High-Risk Participants (n = 30)

During the 3-month follow-up period, no incidents of sudden cardiac arrest were reported among the screened participants. Compliance with the preventive protocol was high (92%) among the high-risk group. The reduction in adverse cardiac events due to early intervention showed a statistically significant association (p = 0.03) when analyzed using chi-square testing (Table 3).

Table 3. Cardiac Event Outcomes at 3-Month Follow-up

These findings suggest that early screening and risk-based management led to effective prevention of sudden cardiac arrest in the study population (Tables 1–3).

Sudden cardiac arrest (SCA) continues to be a major public health concern due to its abrupt onset and high fatality rate, often occurring in individuals without prior symptoms or diagnosed heart disease. In the present study, early screening using a combination of electrocardiography, echocardiography, cardiac biomarkers, and risk scoring systems was found to be effective in identifying individuals at increased risk of SCA, thereby enabling timely preventive interventions.

The prevalence of abnormal ECG findings in our study (24%) aligns with earlier research that highlights ECG as a reliable initial screening tool for detecting conduction abnormalities and ventricular repolarization defects, which are common precursors to SCA (1,2). Similarly, echocardiographic findings of structural heart disease or reduced ejection fraction in 18% of participants are consistent with existing literature emphasizing the role of cardiac imaging in risk stratification (3,4). Notably, even asymptomatic left ventricular dysfunction has been strongly associated with increased mortality risk from cardiac causes (5).

Serum troponin-I elevation in 12% of our participants suggested the presence of silent myocardial injury, which, as previous studies indicate, may be predictive of future cardiovascular events and warrants prompt attention (6,7). Cardiac biomarkers, particularly high-sensitivity troponin assays, are increasingly being used in screening protocols due to their sensitivity and prognostic value (8,9). Furthermore, the use of the Framingham Risk Score enabled systematic stratification of participants based on their 10-year cardiovascular risk, reinforcing its utility in community-based screening programs (10).

Importantly, none of the high-risk individuals in this study experienced SCA during the follow-up period, and only one developed a non-fatal arrhythmia that was successfully managed. These outcomes support the hypothesis that early diagnosis and tailored management can significantly reduce the incidence of fatal cardiac events (11). Similar results have been demonstrated in large-scale trials such as MADIT-II and SCD-HeFT, where prophylactic implantation of ICDs in selected high-risk populations led to significant reductions in sudden cardiac mortality (12,13).

Our findings further highlight the importance of lifestyle modification and adherence to pharmacologic therapy in cardiovascular risk reduction. Studies have consistently shown that interventions such as smoking cessation, dietary control, physical activity, and medical management with beta-blockers, ACE inhibitors, and statins significantly improve long-term cardiac outcomes (14,15). The high compliance rate (92%) observed among participants also suggests that early engagement and counseling play a pivotal role in patient participation and long-term success.

Despite these encouraging results, certain limitations must be acknowledged. The study duration was relatively short, and the sample size was limited to 100 participants, which may not fully capture long-term outcomes or rare events. Additionally, genetic predispositions and arrhythmic syndromes such as Brugada syndrome or long QT syndrome, which may not manifest on standard tests, were not specifically evaluated. Future studies incorporating genetic screening and extended follow-up may offer more comprehensive insights.

In conclusion, this study reinforces the clinical value of early screening and structured risk assessment in the prevention of sudden cardiac arrest. Implementation of routine cardiac screening in primary care and outpatient settings, especially for individuals with risk factors, could serve as a pivotal strategy in reducing cardiovascular mortality.

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