Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Sudden Death: Arrhythmias and Sport


We know very little about the risk of sudden death associated with exercise in young competitors, so the benefits versus the hazards of sports activity pose a clinical dilemma. However, we know from a study in the Veneto region of Italy that adolescents and young adults involved in competitive sport had a two and a half times higher risk of sudden death. The young competitors who died suddenly were affected by silent cardiovascular diseases, predominantly cardiomyopathies. Sport did not directly cause the deaths, but rather it triggered cardiac arrest in athletes with underlying diseases predisposing them to life-threatening ventricular arrhythmias.

Italy has a mandatory eligibility test involving nearly six million young people every year and the test leans heavily on the use of 12-lead ECG. In one 17-year study by the Centre for Sports Medicine of Padua involving nearly 34,000 athletes under 35 years old, over 1,000 were disqualified from competing on health grounds, 621 (1.8%) because the tests revealed relevant cardiovascular abnormalities.

In the US young athletes had physical examinations and personal and family history investigations, but 12-lead ECG was done only at the doctor’s discretion. The American Heart Association previously assumed that ECG would not be cost-effective for screening. The results of Italy’s 25-year experience of systematic pre-participation evaluation show that the Italian screening method is more sensitive than the limited US protocol. ECG is abnormal in up to 95% of patients with hypertropic cardiomyopathy (HCM), which is the leading cause of sudden death in an athlete. Comparisons between findings in Italy where ECG is used and research in the US showed a similar prevalence of HCM in non-sport sudden cardiac death, but a significant difference – 2% versus 24% – in sports-related cardiovascular events. This suggests we have selectively reduced sports-related sudden death from HCM because the Italian system, using ECG, identifies vulnerable young people.

ECG abnormalities have also been documented in the majority of athletes who died from other arrhythmogenic heart muscle diseases. A number of conditions now being picked up by ECG had only recently been discovered, so diagnosis was increasing. Researchers would shortly be examining the impact on mortality of the increased detection of potentially lethal problems.

From all the evidence that we have from 25 years experience in Italy, we can state unequivocally that screening is warranted. It is ethically and clinically justifiable to make every effort to recognise in good time the diseases that put these athletes at risk, and to reduce fatalities.

A 2005 European Society of Cardiology consensus document recommends that every young athlete involved in organised sport has a rigorous physical examination, a detailed investigation of their personal and family medical history and, most importantly, a 12-lead ECG. The consensus panel recommends that screening should start around the age of 12 years old to 14 years old and be repeated at least every two years. It should be performed by a physician with specific training who could reliably identify clinical symptoms and signs associated with cardiovascular diseases responsible for exercise-related sudden death. Those who tested positive according to set criteria should be referred for more extensive tests, and if that confirmed suspicions, barred from competition and training.

Screening of large athletic populations will have significant socio-economic impact and its implementation across Europe will depend on the different socio-economic and cultural backgrounds as well as on the specific medical systems in place in different countries. However, experience in Italy indicates that the proposed screening design is made feasible because of the limited cost of 12-lead ECG in a mass screening setting.

Gina Dellios | alfa
Further information:

More articles from Health and Medicine:

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

nachricht Researchers identify key step in viral replication
13.03.2018 | University of Pittsburgh Schools of the Health Sciences

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

Im Focus: Locomotion control with photopigments

Researchers from Göttingen University discover additional function of opsins

Animal photoreceptors capture light with photopigments. Researchers from the University of Göttingen have now discovered that these photopigments fulfill an...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

TRAPPIST-1 planets provide clues to the nature of habitable worlds

21.03.2018 | Physics and Astronomy

The search for dark matter widens

21.03.2018 | Materials Sciences

Natural enemies reduce pesticide use

21.03.2018 | Life Sciences

Science & Research
Overview of more VideoLinks >>>