U of T study raises doubts about screening for cardiac arrest among young athletes

Soccer players
Screening exams for cardiac arrest are unlikely to predict an athlete's risk, says a new study co-authored by U of T researchers (photo by Bob Mical via Flickr)


Having your heart stop while playing a sport is extremely rare, but your risk is unlikely to be predicted by screening exams, a new study co-authored by University of Toronto researchers suggests.
Screening may exclude people from engaging in sports when they could do so safely, Dr. Paul Dorian from U of T's Faculty of Medicine tells Reuters Health.
“Among the (cardiac arrest) survivors identified in our study, none had a condition that was likely to have been identified by preparticipation screening,” he and his co-authors write in the study published in the New England Journal of Medicine
“Among the persons who died, our data suggest that systematic preparticipation screening may have identified a maximum of three persons who were at risk for sudden cardiac arrest.” 
The study was based on an analysis of all out-of-hospital cardiac arrests that occurred between 2009 to 2014 in southern Ontario for people aged 12 to 45. 
In that time, there were 74 sport-related cardiac arrests. In 16 cases, a person’s heart stopped during or within an hour of playing a competitive sport; the rest were among people who played a non-competitive sport.
The sports associated with sudden cardiac arrest among competitive athletes were soccer and race events, while among amateur athletes they were gym workouts and running. 
The odds of an athlete suffering a sudden arrest during competition or training were extremely slim: one in 131,600 per year, with 44 per cent surviving and being discharged from hospital.
“The risk in these athletes is extraordinarily small, less than what’s previously been believed,” Dr. Dorian tells Reuters. 

Read the Reuters Health story

Read the research in the New England Journal of Medicine

An expert who was not involved with the study told Reuters that the U of T study suggests that automated external defibrillators ought to be more widely available. 
“We need trainers or security staff or coaches trained in CPR and emergency response, because we’re not going to prevent this problem by screening,” says Dr. Ben Abella, a professor of emergency medicine at the University of Pennsylvania. 
The study was supported by the National Heart, Lung, and Blood Institute and the Canadian Institutes of Health Research.
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