Sports-Related Sudden Cardiac Arrest in Germany

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 onsite SCD-prevention campaigns, with training of CPR and explanation of the efficient use of automated external defibrillators (AEDs), may decrease the burden of SrSCD.

Automated summary

This study established a registry on sports-related sudden cardiac arrest in order to estimate the incidence and describe the etiologies in Germany. Most cases occurred during nonelite competitive or recreational sports, with premature CAD, SADS, and myocarditis as the leading causes in young athletes, and CAD as the predominant cause in athletes aged 35 and above. The importance of country-specific registries for defining screening and prevention strategies was highlighted.