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Sudden cardiac arrest in sports: a video analysis
  1. Didrik Magnus Steinskog,
  2. Erik Ekker Solberg
  1. Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
  1. Correspondence to Dr Didrik Magnus Steinskog, Diakonhjemmet Hospital, Oslo 0370, Norway; didrik.steinskog{at}gmail.com

Abstract

Objectives Information about sudden cardiac arrest (SCA) in sports arises from registries, insurance claims and various reports. Analysing video footage of SCA during sports for scientific purposes has scarcely been done. The objective of this study was to examine videotaped SCA in athletes to better understand the mechanisms of SCA.

Methods Publicly available online video databases were searched for videos displaying SCA in athletes.

Results Thirty-five online videos (26 from professional and 9 from amateur sport; 34 male victims) were obtained. Twenty-one events resulted in survival and 14 in sudden cardiac death. Level of physical activity prior to SCA was assessable in 28 videos; 19 events occurred during low-intensity, 6 during moderate-intensity and 3 during high-intensity activity. SCA predominately occurred during low-intensity compared with both moderate-intensity and high-intensity activities (p<0.01). In 26/35 videos, it was possible to observe if resuscitation was provided. Resuscitation was carried out in 20 cases; cardiopulmonary resuscitation (CPR) alone (8 cases), CPR+defibrillation (10), cardiac thump (1) or shock from an implantable cardioverter defibrillator (1). Thirteen of the 20 cases with resuscitation received an intervention within 1 min after collapse. Survival was high when intervention occurred within 1 min (12/13) compared with those who received delayed (3/5) or no intervention (1/6). Associated signs of SCA such as agonal respirations and seizure-like movements were observed in 66% of the cases.

Conclusions SCA during sport most often occurred during low-intensity activity. Prompt intervention within 1 min demonstrated a high survival rate and should be the standard expectation for witnessed SCA in athletes.

  • sudden cardiac death
  • sudden cardiac arrest
  • resuscitation
  • athlete
  • exercise-induced
  • parasympathetic
  • vagus nerve
  • vagal

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Footnotes

  • Contributors EES was responsible for the idea and concept of the research. DMS and EES was responsible for data collection and data analysis. Both authors were actively involved in the interpretation of the findings. DMS drafted the article, however both authors were actively involved with layout and writing. EES was mostly involved in critical review of the article, however both sides took part. Both DMS and EES approved the final version for publishing. The framework of the study was originated by EES. DMS and EES have worked together with inclusion of material, analysis and writing the paper.

  • Funding The authors have received a minor fund from Raagholtstiftelsen to finance this work.

  • Competing interests EES has previously received lecturer fees from Bayer, Sanofi and MSD.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This article is based on online videos of cardiac arrest in sports that are open to everyone. Information from analysing the videos is further backed up by online articles and video interviews of victims or bystanders which are also available online.

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