Heart of the Matter

December 19, 2017

Researchers in Ontario, Canada have good news and bad news involving sudden cardiac arrest in athletes. The good news is that these instances are rare. The bad news is it doesn’t appear that heart screenings may be an effective way to prevent them.

Titled “Sudden Cardiac Arrest during Participation in Competitive Sports” and published online in the New England Journal of Medicine, the study identified a total of 3,825 out-of-hospital cardiac arrests among persons aged 12 to 45. As ScienceDaily reports, each case occurred in Toronto from 2009 to 2014 during a sporting event. 

According to HealthDay, over the five-year study period, the researchers found that 16 competitive athletes had a cardiac arrest, as did 58 recreational athletes. This means sudden cardiac arrest occurred at a rate of 0.76 cases for every 100,000 athletes per year.

However, of the 16 athletes who suffered cardiac arrest, only three of them had undiagnosed heart conditions that would have been discovered by a screening, such as an electrocardiogram. Paul Dorian, MD, lead author of the study, Department Director of the Division of Cardiology at the University of Toronto, and a Staff Cardiac Electrophysiologist at St. Michael's Hospital in Toronto, stated that these finding reveal the inadequacy of heart screenings. He says that while a small number of cases of sudden cardiac arrest may be caused by identifiable underlying conditions, most cases can’t be.

“In Europe and in the United States, screening programs have been implemented on the assumption that most cases of sudden cardiac arrest during sport can be predicted and prevented by identifying people who are at risk because of a pre-existing condition and withdrawing them from competitive sports,” Dr. Dorian told ScienceDaily. “Our study shows these events are too rare, and the causes are not likely enough to be identified, to warrant screening every athlete who wants to play competitive sports.”

Based on the study’s findings, Dr. Dorian is advocating for the increased availability of defibrillators, which can be used to revive a person who is experiencing cardiac arrest. These, according to Dr. Dorian, are the best defense against sudden cardiac arrest and should therefore always be handy during a sporting event.

“Sudden cardiac arrest in young athletes is a rare but tragic event,” he told ScienceDaily. “We need to find a way to prevent these events while keeping as many kids as we can in the game. The evidence suggests one of the best ways to do that is by installing defibrillators at every sporting arena and field at which competitive sports are played and training bystanders to respond effectively.”

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