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Middle-aged athletes at low risk for sudden cardiac arrest while exercising

Middle-aged athletes are at low risk for having a sudden cardiac arrest while playing sports, and those who do have a greater chance of surviving the usually-fatal condition, shows a new Cedars-Sinai Heart Institute study.

"Because there is so much media attention when someone has a sudden cardiac arrest while playing sports, we want to make sure people know that the benefits of exercise far outweigh the risk of having a cardiac arrest," said Sumeet S. Chugh, M.D., associate director of the Cedars-Sinai Heart Institute and a prominent expert in the diagnosis, treatment and investigation of heart rhythm abnormalities. "Even for middle-aged men, who are more susceptible to heart rhythm disturbances, the risk is quite low."

Although "sudden cardiac arrest" and "heart attack" often are used interchangeably, the terms are not synonymous. Unlike heart attacks (myocardial infarctions), which are typically caused by clogged coronary arteries reducing blood flow to the heart muscle, sudden cardiac arrest is the result of defective electrical activity of the heart. Patients may have little or no warning, and the disorder usually causes instantaneous death.

Sudden cardiac arrest has been blamed for the deaths of journalist Tim Russert and filmmaker John Hughes as well as U.S. Olympic volleyball player Flo Hyman and professional basketball players Pete Maravich and Reggie Lewis.

  • In the study, published in the medical journal Circulation, investigators studied the 1,247 people aged 35-65 from the Portland, Oregon, metropolitan area who had a sudden cardiac arrest between 2002 and 2013. Results include: Just 5 percent, or 63 people, had a sudden cardiac arrest during sports activities.
  • Eighty-seven percent of those who had a sudden cardiac arrest while engaged in sports received cardiopulmonary resuscitation.
  • Fifty-three percent of patients who had a sudden cardiac arrest while not playing sports received cardiopulmonary resuscitation.
  • The survival rate of 23 percent was markedly higher for those who had a sudden cardiac arrest while exercising compared to just 13 percent for those who had a sudden cardiac arrest during other activities.
  • Men were seven times more likely than women to have a sports-related sudden cardiac arrest.

"The chance of surviving sudden cardiac arrest is better if the episode occurs while exercising, probably because there are likely to be others around who can do chest compressions until paramedics arrive," said Chugh, the Pauline and Harold Price Chair in Cardiac Electrophysiology Research.

In addition to his leadership role at the Cedars-Sinai Heart Institute, Chugh heads the Oregon Sudden Unexpected Death Study, a comprehensive, 16-hospital, multi-year assessment of cardiac deaths in the 1 million population Portland, Oregon, metropolitan area. The data collected in the study - now ongoing for more than a decade - provides Chugh and his team with unique, community-based information to mine for answers to what causes sudden cardiac arrest. Chugh's Sudden Death Genomics Laboratory at the Cedars-Sinai Heart Institute is funded by two previous grants from the National Heart, Lung, and Blood Institute that also enable ongoing work on solving the mechanisms of sudden cardiac arrest.

"What this study shows is that most middle-aged athletes don't need to worry about sudden cardiac arrest while they are working out," Chugh said. "As our population ages, it's important to know that older people can exercise without worrying about triggering a heart rhythm disturbance."




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