Sudden Cardiac Death in Athletes: Magnitude, Causes, and Prevention Strategies - A Literature Review
DOI:
https://doi.org/10.12775/QS.2024.19.54350Keywords
Sudden cardiac death, Sports, athletes, exercise, cardiovascular diseases, Arrhythmogenic right ventricular cardiomyopathy, cardiomyopathy, electrocardiogram, risk factorsAbstract
Sudden cardiac death (SCD) in athletes, though rare, is the leading cause of exercise-related mortality and poses significant concern due to the symbolic health and vitality of athletes. This review examines the epidemiology, causes, and prevention strategies of SCD in athletes. SCD, defined as sudden death presumed to be of cardiac origin within one hour of symptom onset, affects athletes variably depending on age, race, and type of sports. Key causes include hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC) in younger athletes, and coronary artery disease (CAD) in older athletes. Ion channelopathies and structural heart diseases also contribute significantly. Preparticipation screening (PPE) involving ECGs, lifestyle adjustments, and medical interventions are critical in prevention. Continuous research and adaptive guidelines are essential for safeguarding athletes against these fatal events.
Keywords: sudden cardiac death, athletes, sports, exercise, cardiovascular diseases, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, coronary artery disease, ion channelopathies, long QT syndrome, Brugada syndrome, preparticipation screening, electrocardiogram (ECG), risk factors, prevention strategies.
References
Harmon KG, Drezner JA, Wilson MG, Sharma S. Incidence of sudden cardiac death in athletes: a state-of-the-art review. Br J Sports Med. 2014 Aug;48(15):1185-92.
La Gerche A, Heidbuchel H. Can intensive exercise harm the heart? You can get too much of a good thing. Circulation. 2014 Sep 16;130(12):992-1002.
Levine BD. Can intensive exercise harm the heart? The benefits of competitive endurance training for cardiovascular structure and function. Circulation. 2014 Sep 16;130(12):987-91.
Pate RR. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995; 273:402‐407.
Fletcher GF, Balady G, Blair SN, et al. Statement on exercise: benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation. 1996;94: 857‐862.
Manson JE, Hu FB, Rich‐Edwards JW, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. N Engl J Med. 1999; 341:650‐658.
Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000; 343:1355‐1361.
Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med. 1984; 311:874‐877.
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE. Triggering of acute myocardial infarction by heavy physical exertion—protection against triggering by regular exertion. N Engl J Med. 1993; 329:1677‐1683.
Maron BJ. The paradox of exercise. N Engl J Med. 2000;343: 1409‐1411.
Jouven X, Zureik M, Desnos M, Courbon D, Ducimetière P. Longterm outcome in asymptomatic men with exercise‐induced premature ventricular depolarizations. N Engl J Med. 2000;343: 826‐833.
Priori, S.G.; Blomström-Lundqvist, C.; Mazzanti, A.; Blom, N.; Borggrefe, M.; Camm, J.; Elliott, P.M.; Fitzsimons, D.; Hatala, R.; Hindricks, G.; et al. 2015 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. Eur. Heart J. 2015, 36, 2793–2867.
Maron, B.J.; Harris, K.M.; Thompson, P.D.; Eichner, E.R.; Steinberg, M.H. Eligibility and Disqualification Recommendations for Competitive Athletes with Cardiovascular Abnormalities: Task Force 14: Sickle Cell Trait: A Scientific Statement from the American Heart Association and American College of Cardiology. J. Am. Coll. Cardiol. 2015, 66, 2444–2446.
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021; 42:17–96.
Corrado D, Zorzi A. Sudden death in athletes. Int J Cardiol 2017; 237:67–70.
Risgaard B, Winkel BG, Jabbari R, Glinge C, Ingemann-Hansen O, Thomsen JL, et al. Sports-related sudden cardiac death in a competitive and a noncompetitive athlete population aged 12 to 49 years: data from an unselected nationwide study in Denmark. Heart Rhythm 2014; 11:1673–1681.
Holst AG, Winkel BG, Theilade J, et al. Incidence and etiology of sports‐related sudden cardiac death in Denmark—implications for preparticipation screening. Heart Rhythm. 2010; 7:1365‐1371.
Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, Cause, and Comparative Frequency of Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A Decade in Review. Circulation. 2015;132(1):10-19.
Van Camp SP, Bloor CM, Mueller FO, Cantu RC, Olson HG. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995; 27:641–7.
Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42:1959–63.
Harmon KG, Zigman M, Drezner JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis. J Electrocardiol 2015; 48:329–38.
Pelto HF, Drezner JA. Design and implementation of an emergency action plan for sudden cardiac arrest in sport. J Cardiovasc Translational Res. 2020; 13:331‐338.
Gronholt‐Pedersen J. Eriksen had cardiac arrest, but test results are normal, Danish team doctor says [Internet]. Reuters. 2021.
Corrado, D.; Zorzi, A. Sudden Cardiac Death in Young People and Athletes. Ital. J. Med. 2018, 12, 74–87.
Emery, M.S.; Kovacs, R.J. Sudden Cardiac Death in Athletes. JACC Heart Fail. 2018, 6, 30–40.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980‐2006. Circulation. 2009; 119: 1085‐1092.
Maron BJ, Haas TS, Murphy CJ, Ahluwalia A, Rutten‐Ramos S. Incidence and causes of sudden death in US college athletes. JACC. 2014; 63:1636‐1643.
De Noronha, S.V.; Sharma, S.; Papadakis, M.; Desai, S.; Whyte, G.; Sheppard, M.N. Aetiology of Sudden Cardiac Death in Athletes in the United Kingdom: A Pathological Study. Heart 2009, 95, 1409–1414.
Suarez-Mier MP, Aguilera B, Mosquera RM, Sanchez-de-Leon MS. Pathology of sudden death during recreational sports in Spain. Forensic Sci Int 2013; 226:188-196.
Papadakis M, Sharma S, Cox S, Sheppard MN, Panoulas VF, Behr ER. The magnitude of sudden cardiac death in the young: a death certificate‐based review in England and Wales. Europace. 2009; 11: 1353‐1358.
Corrado D. Sudden cardiac death in young people with apparently normal heart. Cardiovasc Res. 2001; 50:399‐408.
Puranik R, Chow CK, Duflou JA, Kilborn MJ, McGuire MA. Sudden death in the young. Heart Rhythm. 2005; 2:1277‐1282. 2931
Eckart RE, Scoville SL, Campbell CL, et al. Sudden death in young adults: a 25‐year review of autopsies in military recruits. Ann Intern Med. 2004; 141:829‐834.
Eckart RE, Shry EA, Burke AP, et al. Sudden death in young adults. JACC. 2011; 58:1254‐1261.
Harmon KG, Drezner JA, Maleszewski JJ, et al. Pathogeneses of sudden cardiac death in national collegiate athletic association athletes. Circulation: Arrhythmia Electrophysiol. 2014; 7:198‐204. 3234
Maron BJ. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA. 1996; 276: 199‐204.
Maron BJ. Sudden death in young athletes. N Engl J Med 2003;349(11):1064-75.
Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, et al. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2008; 29:270–276. https://doi.org/10.1093/eurheartj/ehm342.
Bagnall RD, Weintraub RG, Ingles J, et al. A prospective study of sudden cardiac death among children and young adults. N Engl J Med 2016; 374:2441–52.
Alpert C, Day SM, Saberi S. Sports and exercise in athletes with hypertrophic cardiomyopathy. Clin Sports Med 2015; 34:489–505.
Maron BJ, Rowin EJ, Casey SA, Maron MS. How hypertrophic cardiomyopathy became a contemporary treatable genetic disease with low mortality. JAMA Cardiology 2016; 1:98.
Finocchiaro, G.; Papadakis, M.; Robertus, J.L.; Dhutia, H.; Steriotis, A.K.; Tome, M.; Mellor, G.; Merghani, A.; Malhotra, A.; Behr, E.; et al. Etiology of Sudden Death in Sports Insights from a United Kingdom Regional Registry. J. Am. Coll. Cardiol. 2016, 67, 2108–2115.
Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J 2010; 31:806–14. https://doi.org/10.1093/ eurheartj/ehq025.
Saberniak J, Hasselberg NE, Borgquist R, Platonov PG, Sarvari SI, Smith H, et al. Vigorous physical activity impairs myocardial function in patients with arrhythmogenic right ventricular cardiomyopathy and in mutation positive family members. Eur J Heart Fail 2014; 16:1337–1344.
Lie ØH, Dejgaard LA, Saberniak J, Rootwelt C, Stokke MK, Edvardsen T, et al. Harmful effects of exercise intensity and exercise duration in patients with arrhythmogenic cardiomyopathy. JACC Clin Electrophysiol 2018; 4:744–753.
James CA, Bhonsale A, Tichnell C, Murray B, Russell SD, Tandri H, et al. Exercis increases age-related penetrance and arrhythmic risk in arrhythmogenic right ventricular dysplasia/cardiomyopathy-associated desmosomal mutation carriers. J Am Coll Cardiol 2013; 62:1290–1297.
Sawant AC, te Riele ASJM, Tichnell C, Murray B, Bhonsale A, Tandri H, et al. Safety of American Heart Association-recommended minimum exercise for desmosomal mutation carriers. Heart Rhythm 2016; 13:199–207.
Pelliccia A, Lemme E, Maestrini V, Di Paolo FM, Pisicchio C, Di Gioia G, et al. Does sport participation worsen the clinical course of hypertrophic cardiomyopathy? Clinical outcome of hypertrophic cardiomyopathy in athletes. Circulation 2018; 137:531–533.
Pelliccia, A.; Culasso, F.; Di Paolo, F.M.; Maron, B.J. Physiologic Left Ventricular Cavity Dilatation in Elite Athletes. Ann. Intern. Med. 1999, 130, 23–31.
Skjølsvik ET, Hasselberg NE, Dejgaard LA, Lie ØH, Andersen K, Holm T, et al. Exercise is associated with impaired left ventricular systolic function in patients with lamin A/C genotype. J Am Heart Assoc 2020;9: e012937.
Priori SG, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M, et al. Risk stratification in the long-QT syndrome. N Engl J Med 2003; 348:1866–1874.
Skinner JR, Winbo A, Abrams D, Vohra J, Wilde AA. Channelopathies that lead to sudden cardiac death: clinical and genetic aspects. Heart, Lung Circ. 2019;28:22‐30.
Moss AJ, Schwartz PJ, Crampton RS, Tzivoni D, Locati EH, MacCluer J, et al. The long QT syndrome. Prospective longitudinal study of 328 families. Circulation 1991; 84:1136–1144.
Schwartz, P.J.; Priori, S.G.; Spazzolini, C.; Moss, A.J.; Vincent, G.M.; Napolitano, C.; Denjoy, I.; Guicheney, P.; Breithardt, G.; Keating, M.T.; et al. Genotype-Phenotype Correlation in the Long-QT Syndrome. Circulation 2001, 103, 89–95.
Timmermans, C.; Smeets, J.L.R.M.; Rodriguez, L.-M.; Vrouchos, G.; van den Dool, A.;Wellens, H.J.J. Aborted Sudden Death in the Wolff-Parkinson-White Syndrome. Am. J. Cardiol. 1995, 76, 492–494.
Pappone C, Vicedomini G, Manguso F, Saviano M, Baldi M, Pappone A, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation 2014; 130:811–819.
Obeyesekere MN, Leong-Sit P, Massel D, Manlucu J, Modi S, Krahn AD, et al. Risk of arrhythmia and sudden death in patients with asymptomatic preexcitation: a meta-analysis. Circulation 2012; 125:2308–2315.
Heidbuchel H, Adami PE, Antz M, Braunschweig F, Delise P, Scherr D, et al. Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions: part 1: supraventricular arrhythmias. A position statement of the Section of Sports Cardiology and Exercise from the European Association of Preventive Cardiology (EAPC) and the European Heart Rhythm Association (EHRA), both associations of the European Society of Cardiology. Eur J Prev Cardiol 2020; 28:1539–1551.
Pappone C, Santinelli V, Manguso F, Augello G, Santinelli O, Vicedomini G, et al. A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff-Parkinson-White syndrome. N Engl J Med 2003; 349:1803–1811.
Harmon KG, Asif IM, Maleszewski JJ, Owens DS, Prutkin JM, Salerno JC, Zigman ML, Ellenbogen R, Rao AL, Ackerman MJ, Drezner JA. Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes: a decade in review. Circulation 2015; 132:10-19.
Caforio ALP, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Helio T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss H-P, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on myocardial and pericardial diseases. Eur Heart J 2013; 34:2636-2648.
Sinagra G, Anzini M, Pereira NL, Bussani R, Finocchiaro G, Bartunek J, Merlo M. Myocarditis in clinical practice. Mayo Clin Proc 2016; 91:1256-1266.
Breinholt JP, Moulik M, Dreyer WJ, Denfield SW, Kim JJ, Jefferies JL, Rossano JW, Gates CM, Clunie SK, Bowles KR, Kearney DL, Bowles NE, Towbin JA. Viral epidemiologic shift in inflammatory heart disease: the increasing involvement of parvovirus B19 in the myocardium of pediatric cardiac transplant patients. J Heart Lung Transplant 2010; 29:739-746.
Yilmaz A, Klingel K, Kandolf R, Sechtem U. A geographical mystery: do cardiotropic viruses respect national borders? J Am Coll Cardiol 2008; 52:82; author reply 82-83.
Bohm P, Scharhag J, Meyer T. Data from a nationwide registry on sports related sudden cardiac deaths in Germany. Eur J Prev Cardiol 2016; 23:649-656.
Phillips M, Robinowitz M, Higgins JR, Boran KJ, Reed T, Virmani R. Sudden cardiac death in Air Force recruits. A 20-year review. JAMA 1986; 256:2696-2699.
Pelliccia A, Corrado D, Bjornstad HH, Panhuyzen-Goedkoop N, Urhausen A, Carre F, Anastasakis A, Vanhees L, Arbustini E, Priori S. Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis. Eur J Cardiovasc Prev Rehabil 2006; 13:876-885.
Maron BJ, Udelson JE, Bonow RO, Nishimura RA, Ackerman MJ, Estes NAM 3rd, Cooper LTJ, Link MS, Maron MS. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 3: Hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis. A scientific statement from the American Heart Association and American College of Cardiology. Circulation 2015;132: e273-280.
Giri S, Thompson PD, Kiernan FJ, Clive J, Fram DB, Mitchel JF, Hirst JA, McKay RG, Waters DD. Clinical and angiographic characteristics of exertion-related acute myocardial infarction. JAMA 1999; 282:1731-1736.
Mittleman MA, Maclure M, Tofler GH, Sherwood JB, Goldberg RJ, Muller JE. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 1993; 329:1677-1683.
Siscovick DS, Weiss NS, Fletcher RH, Lasky T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med 1984; 311:874-877.
Waller BF, Roberts WC. Sudden death while running in conditioned runners aged 40 years or over. Am J Cardiol 1980; 45:1292-1300.
Noakes TD, Opie LH, Rose AG, Kleynhans PH, Schepers NJ, Dowdeswell R. Autopsy-proved coronary atherosclerosis in marathon runners. N Engl J Med 1979; 301:86-89.
Marijon E, Tafflet M, Celermajer DS, Dumas F, Perier M-C, Mustafic H, Toussaint J-F, Desnos M, Rieu M, Benameur N, Le Heuzey J-Y, Empana J-P, Jouven X. Sports-related sudden death in the general population. Circulation 2011; 124:672-681.
Malhotra A, Dhutia H, Finocchiaro G, Gati S, Beasley I, Clift P, Cowie C, Kenny A, Mayet J, Oxborough D, Patel K, Pieles G, Rakhit D, Ramsdale D, Shapiro L, Somauroo J, Stuart G, Varnava A, Walsh J, Yousef Z, Tome M, Papadakis M, Sharma S. Outcomes of cardiac screening in adolescent soccer players. N Engl J Med 2018; 379:524-534.
Aengevaeren VL, Mosterd A, Braber TL, Prakken NHJ, Doevendans PA, Grobbee DE, Thompson PD, Eijsvogels TMH, Velthuis BK. Relationship between lifelong exercise volume and coronary atherosclerosis in athletes. Circulation 2017; 136:138-148.
Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corra U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Lochen M-L, Lollgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM, Binno S. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2016; 37:2315-2381.
Niebauer J, Borjesson M, Carre F, Caselli S, Palatini P, Quattrini F, Serratosa L, Adami PE, Biffi A, Pressler A, Schmied C, van Buuren F, Panhuyzen-Goedkoop N, Solberg E, Halle M, La Gerche A, Papadakis M, Sharma S, Pelliccia A. Recommendations for participation in competitive sports of athletes with arterial hypertension: a position statement from the sports cardiology section of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2018; 39:3664-3671.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39:3021-3104.
Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, Ryan ED. Resistance training for older adults: position statement from the National Strength and Conditioning Association. J Strength Cond Res 2019; 33:2019-2052.
Anderson L, Thompson DR, Oldridge N, Zwisler A-D, Rees K, Martin N, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2016; CD001800.
Borjesson M, Dellborg M, Niebauer J, LaGerche A, Schmied C, Solberg EE, Halle M, Adami E, Biffi A, Carre F, Caselli S, Papadakis M, Pressler A, Rasmusen H, Serratosa L, Sharma S, van Buuren F, Pelliccia A. Recommendations for participation in leisure time or competitive sports in athletes-patients with coronary artery disease: a position statement from the Sports Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2019; 40:13-18.
Priori SG, Blomstrom-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, Kirchhof P, Kjeldsen K, Kuck KH, Hernandez-Madrid A, Nikolaou N, Norekval TM, Spaulding C, Van Veldhuisen DJ. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). EP Europace 2015; 17:1601-1687.
Lin S, Tremmel JA, Yamada R, Rogers IS, Yong CM, Turcott R, McConnell MV, Dash R, Schnittger I. A novel stress echocardiography pattern for myocardial bridge with invasive structural and hemodynamic correlation. J Am Heart Assoc 2013;2: e000097.
Grani C, Benz DC, Steffen DA, Giannopoulos AA, Messerli M, Pazhenkottil AP, Gaemperli O, Gebhard C, Schmied C, Kaufmann PA, Buechel RR. Sports behavior in middle-aged individuals with anomalous coronary artery from the opposite sinus of Valsalva. Cardiology 2018; 139:222-230.
Grani C, Benz DC, Steffen DA, Clerc OF, Schmied C, Possner M, Vontobel J, Mikulicic F, Gebhard C, Pazhenkottil AP, Gaemperli O, Hurwitz S, Kaufmann PA, Buechel RR. Outcome in middle-aged individuals with anomalous origin of the coronary artery from the opposite sinus: a matched cohort study. Eur Heart J 2017; 38:2009-2016.
Kastellanos, S.; Aznaouridis, K.; Vlachopoulos, C.; Tsiamis, E.; Oikonomou, E.; Tousoulis, D. Overview of Coronary Artery Variants, Aberrations and Anomalies. World J. Cardiol. 2018, 10, 127–140.
Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, et al. 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2020;142(25): e533-57.
Egger, F.; Scharhag, J.; Kästner, A.; Dvoˇrák, J.; Bohm, P.; Meyer, T. FIFA Sudden Death Registry (FIFA-SDR): A Prospective, Observational Study of Sudden Death in Worldwide Football from 2014 to 2018. Br. J. Sports Med. 2020.
Maron BJ, Levine BD, Washington RL, Baggish AL, Kovacs RJ, Maron MS. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 2: preparticipation screening for cardiovascular disease in competitive athletes: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol 2015; 66:2356–61.
Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism. Circulation 2007;115: 1643–55.
Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular preparticipation screening of competitive athletes: a statement for health professionals from the Sudden Death Committee (Clinical Cardiology) and Congenital Cardiac Defects Committee (Cardiovascular Disease in the Young), American Heart Association. Circulation 1996; 94:850–6.
Corrado D, Pelliccia A, Bjørnstad HH, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Eur Heart J 2005; 26:516–24.
American Academy of Family Physicians AAoP, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. In: Bernhardt D, Roberts W, editors. Preparticipation physical evaluation. 4th edition. Elk Grove Village, IL: American Academy of Pediatrics; 2012.
Drezner JA, O’Connor FG, Harmon KG, et al. AMSSM position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations, and future directions. Clin J Sport Med 2016; 26:347–61.
Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med. 1998; 339:364‐369.
Corrado D, Pelliccia A, Bjørnstad HH, Vanhees L, Biffi A, Borjesson M, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J 2005; 26:516–524.
Corrado D, Schmied C, Basso C, Borjesson M, Schiavon M, Pelliccia A, et al. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes? Eur Heart J 2011; 32:934–944. 101
Baggish AL, Hutter AM, Wang F, Yared K, Weiner RB, Kupperman E, et al. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med 2010; 152:269–275. 102
Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006; 296:1593‐1601. 98
Bille, K.; Figueiras, D.; Schamasch, P.; Kappenberger, L.; Brenner, J.I.; Meijboom, F.J.; Meijboom, E.J. Sudden Cardiac Death in Athletes: The Lausanne Recommendations. Eur. J. Cardiovasc. Prev. Rehabil. 2006, 13, 859–875. 97
Pelliccia A, Corrado D. The Israel screening failure. JACC. 2011;58: 989‐990.
Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation. 2007 Nov 27;116(22):2616-26; discussion 2626.
Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation. 2007 Nov 27;116(22):2610-4; discussion 2615.
Sharma S, Estes NAM, Vetter VL, Corrado D. Clinical decisions. Cardiac screening before participation in sports. N Engl J Med 2013; 369:2049–2053.
Sarto P, Zorzi A, Merlo L, Vessella T, Pegoraro C, Giorgiano F, et al. Serial versus single cardiovascular screening of adolescent athletes. Circulation 2021;143: 1729–1731.
Steinvil A, Chundadze T, Zeltser D, Rogowski O, Halkin A, Galily Y, et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? J Am Coll Cardiol 2011; 57:1291–1296.
Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12‐lead electrocardiogram in the athlete. Eur Heart J. 2010; 31:243‐259.
Papadakis M, Carre F, Kervio G, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro‐Caribbean origin. Eur Heart J. 2011;32:2304‐2313.
Sheikh N, Papadakis M, Carre F, et al. Cardiac adaptation to exercise in adolescent athletes of African ethnicity: an emergent elite athletic population. Br J Sports Med. 2013;47:585‐592.
Papadakis M, Basavarajaiah S, Rawlins J, et al. Prevalence and significance of T‐wave inversions in predominantly Caucasian adolescent athletes. Eur Heart J. 2009;30:1728‐1735.
Migliore F, Zorzi A, Michieli P, et al. Prevalence of cardiomyopathy in Italian asymptomatic children with electrocardiographic T‐wave inversion at preparticipation screening. Circulation. 2012;125: 529‐538.
Pelliccia A, Culasso F, Di Paolo FM, et al. Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre‐participation cardiovascular screening. Eur Heart J. 2007;28: 2006‐2010.
Brosnan M, La Gerche A, Kalman J, et al. Comparison of frequency of significant electrocardiographic abnormalities in endurance versus nonendurance athletes. Am J Cardiol. 2014;113:1567‐1573.
Drezner JA, Ackerman MJ, Anderson J, et al. Electrocardiographic interpretation in athletes: the ‘Seattle Criteria’. Br J Sports Med. 2013; 47:122‐124.
Sheikh N, Papadakis M, Ghani S, et al. Comparison of electrocardiographic criteria for the detection of cardiac abnormalities in elite black and White athletes. Circulation. 2014; 129:1637‐1649.
Drezner, J.A.; Sharma, S.; Baggish, A.; Papadakis, M.;Wilson, M.G.; Prutkin, J.M.; Gerche, A.L.; Ackerman, M.J.; Borjesson, M.; Salerno, J.C.; et al. International Criteria for Electrocardiographic Interpretation in Athletes: Consensus Statement. Br. J. Sports Med. 2017, 51, 704–731.
Rizzo M, Spataro A, Cecchetelli C, Quaranta F, Livrieri S, Sperandii F, et al. Structural cardiac disease diagnosed by echocardiography in asymptomatic young male soccer players: implications for pre-participation screening. Br J Sports Med 2012; 46:371–373.
Heidbuchel H, Arbelo E, D’Ascenzi F, Borjesson M, Boveda S, Castelletti S, et al. Recommendations for participation in leisure-time physical activity and competitive sports of patients with arrhythmias and potentially arrhythmogenic conditions Part 2: ventricular arrhythmias, channelopathies, and implantable defibrillators. Europace 2021; 23:147–148.
Vettor, G.; Zorzi, A.; Basso, C.; Thiene, G.; Corrado, D. Syncope as a Warning Symptom of Sudden Cardiac Death in Athletes. Cardiol. Clin. 2015, 33, 423–432.
Avella, A.; D’amati, G.; Pappalardo, A.; Re, F.; Silenzi, P.F.; Laurenzi, F.; de Girolamo, P.; Pelargonio, G.; Russo, A.D.; Baratta, P.; et al. Diagnostic Value of Endomyocardial Biopsy Guided by Electroanatomic Voltage Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia. J. Cardiovasc. Electrophysiol. 2008, 19, 1127–1134.
Link, M.S.; Mark Estes, N.A. Athletes and Arrhythmias. J. Cardiovasc. Electrophysiol. 2010, 21, 1184–1189.
American College of Sports Medicine Position Stand and American Heart Association. Recommendations for cardiovascular screening, staffing, and emergency policies at health/fitness facilities. Med Sci Sports Exerc. 1998 Jun;30(6):1009-18.
Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol. 2002 Oct 16;40(8):1531-40.
Radmilovic, J.; D’Andrea, A.; D’Amato, A.; Tagliamonte, E.; Sperlongano, S.; Riegler, L.; Scarafile, R.; Forni, A.; Muscogiuri, G.; Pontone, G.; et al. Echocardiography in Athletes in Primary Prevention of Sudden Death. J. Cardiovasc. Echogr. 2019, 29, 139–148.
Mavrogeni, S.I.; Bacopoulou, F.; Apostolaki, D.; Chrousos, G.P. Sudden Cardiac Death in Athletes and the Value of Cardiovascular Magnetic Resonance. Eur. J. Clin. Investig. 2018, 48, e12955.
Andreini, D.; Dello Russo, A.; Pontone, G.; Mushtaq, S.; Conte, E.; Perchinunno, M.; Guglielmo, M.; Coutinho Santos, A.; Magatelli, M.; Baggiano, A.; et al. CMR for Identifying the Substrate of Ventricular Arrhythmia in Patients with Normal iniEchocardiography. JACC Cardiovasc. Imaging 2020, 13, 410–421.
Casella, M.; Dello Russo, A.; Vettor, G.; Lumia, G.; Catto, V.; Sommariva, E.; Ribatti, V.; Biagioli, V.; Tundo, F.; Carbucicchio, C.; et al. Electroanatomical Mapping Systems and Intracardiac Echo Integration for Guided Endomyocardial Biopsy. Expert Rev. Med. Devices 2017, 14, 609–619.
Wellens HJ, Rodriguez LM, Timmermans C, Smeets JP. The asymptomatic patient with the Wolff-Parkinson-White electrocardiogram. Pacing Clin Electrophysiol 1997; 20:2082-2086.
Michela, C.; Antonio, D.R.; Marco, B.; Valentina, C.; Edoardo, C.; Elena, S.; Alessio, G.; Giulia, V.; Fabrizio, T.; Rita, S.; et al. Diagnostic Yield of Electroanatomic Voltage Mapping in Guiding Endomyocardial Biopsies. Circulation 2020, 142, 1249–1260.
Barry MJ, Edgman-Levitan S. Shared decision making—the pinnacle of patient-centred care. N Engl J Med 2012; 366:780–1.
Hainline B, Drezner J, Baggish A, et al. Interassociation consensus statement on cardiovascular care of college student‐athletes. J Athl Train. 2016; 51:344‐357.
Casa DJ, Almquist J, Anderson SA, et al. The inter‐association task force for preventing sudden death in secondary school athletics programs: best‐practices recommendations. J Athl Train. 2013;48: 546‐553.
Link MS, Myerburg RJ, Estes NA. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 12: Emergency action plans, resuscitation, cardiopulmonary resuscitation, and automated external defibrillators: a scientific statement from the American Heart Association and American College of Cardiology. Circulation. 2015;132: 334‐338. doi:10.1161/CIR.0000000000000248
Dvorak J, Kramer EB, Schmied CM, et al. The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care. Br J Sports Med. 2013; 47:1199‐1202.
Ruppert M, Reith MW, Widmann JH, et al. Checking for breathing: evaluation of the diagnostic capability of emergency medical services personnel, physicians, medical students, and medical laypersons. Ann Emerg Med. 1999; 34:720‐729.
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