Abstract
Background
Knowledge about causes of sports-related sudden cardiac arrest (SrSCA) may influence
national strategies to prevent such events. Therefore, we established a prospective
registry on SrSCA to estimate the incidence and in particular describe the etiologies
of SrSCA in the general population in Germany.
Methods
The registration of SrSCA based upon 4 pillars: a web-based platform to record SrSCA
cases in competitive and recreational athletes, media-monitoring, cooperation with
the German Resuscitation Registry, and 15 institutes of forensic medicine.
Results
After an observation period of 6 years, a total of 349 cases was recorded (mean age
48.0 ± 12.7 years); 109 subjects survived. Most of the cases occurred during nonelite
competitive or recreational sports. Bystander cardiopulmonary resuscitation (CPR)
was initiated in 262 cases (75%); however, rhythm analysis and defibrillation (if
indicated) was mainly performed by medical services. In patients ≤ 35 years of age,
premature coronary artery disease (CAD) and sudden arrhythmic death syndrome (SADS)
prevailed, followed by myocarditis. In athletes ≥ 35 years of age, CAD predominated.
Conclusions
Country-specific registries are necessary to define the national screening and prevention
strategy optimally. In Germany, premature CAD, SADS, and myocarditis are the leading
causes of SrSCA in young athletes, reinforcing the great disparity of the prevalence
of cardiac diseases among different countries. Extension of on-site SCD-prevention
campaigns, with training of CPR and explanation of the efficient use of automated
external defibrillators (AEDs), may decrease the burden of SrSCD.
Résumé
Contexte
La connaissance des causes de l’arrêt cardiaque soudain lié à la pratique sportive
(ACSs) pourrait éclairer les stratégies nationales visant à prévenir la survenue de
tels événements. Nous avons donc constitué un registre prospectif des ACSs afin d’estimer
l’incidence des ACSs et, plus particulièrement, d’en décrire les causes dans la population
générale en Allemagne.
Méthodologie
Le registre des ACSs repose sur quatre sources de données principales : 1) une plateforme
Web pour le signalement des cas d’ACSs survenus chez des athlètes de compétition ou
des sportifs occasionnels; 2) la surveillance des médias; 3) une collaboration avec
le German Resuscitation Registry (registre allemand des réanimations); et 4) une collaboration
avec 15 établissements médico-légaux.
Résultats
Après 6 années d’observation, un nombre total de 349 cas ont été répertoriés (âge
moyen : 48,0 ± 12,7 ans), parmi lesquels 109 sujets ont survécu. La plupart des cas
sont survenus dans le cadre de compétitions ou d’activités sportives de niveau amateur.
La réanimation cardiorespiratoire (RCR) a été amorcée par un témoin dans 262 cas (75
%), mais l’analyse du rythme cardiaque et la défibrillation (si elle était indiquée)
ont été effectuées principalement par du personnel médical. Chez les sujets de 35
ans ou moins, les causes prédominantes étaient la coronaropathie prématurée et le
syndrome de la mort subite par arythmie (SMSA), suivis de la myocardite. Chez les
athlétes de plus de 35 ans, la coronaropathie était plus fréquente.
Conclusions
Pour définir de manière optimale les stratégies nationales de dépistage et de prévention,
chaque pays doit établir son propre registre. En Allemagne, la coronaropathie prématurée,
le SMSA et la myocardite sont les principales causes d’ACSs chez les jeunes athlètes,
ce qui vient confirmer la grande disparité observée dans différents pays quant à la
prévalence des maladies cardiaques. L’intensification de campagnes de prévention de
la mort cardiaque subite sur place lors des événements sportifs, jumelée à une formation
en RCR et sur l’utilisation efficiente d’un défibrillateur externe automatisé (DEA),
pourrait contribuer à réduire le fardeau de l’ACSs.
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Article Info
Publication History
Published online: March 23, 2020
Accepted:
March 16,
2020
Received:
November 18,
2019
Footnotes
See page 111 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
