Incidence and etiology of sports-related sudden cardiac death in Denmark—Implications for preparticipation screening

Holst, Anders G.; Winkel, Bo Gregers; Theilade, Juliane; Kristensen, Ingrid Bayer; Thomsen, Jørgen Lange; Ottesen, Gyda Lolk; Svendsen, Jesper Hastrup; Haunsø, Stig; Prescott, Eva; Tfelt-Hansen, Jacob

doi:10.1016/j.hrthm.2010.05.021

Cited by 208 publications

(144 citation statements)

References 16 publications

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“…16 In other studies, the reported incidence of SCD ranges from 0.24 to 3.8 per 100,000, with higher rates seen in African and Afro-Caribbean athletes. [18][19][20]21 and genetic channelopathies account for most of the remainder (see Table 1). 6,22 SCD accounts for 50 % of all CAD-related deaths.…”

Section: Department Of Defense Cardiovascular Death Registry In the Umentioning

confidence: 99%

“…19,49,50 There is evidence, however, that HCM may not be the major cause of SCD in athletes. 16,20 Autopsies in deceased NCAA athletes most often reveal a structurally normal heart (25 %), followed by coronary artery anomalies (11 %), myocarditis (9 %), ARVC (5 %) and aortic dissection (5 %), with HCM only demonstrated in 8 % of individuals. 16 Findings from the Race Associated Cardiac Arrest Event Registry (RACER) indicate that marathons and half- …”

Section: Department Of Defense Cardiovascular Death Registry In the Umentioning

confidence: 99%

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A Clinical Perspective on Sudden Cardiac Death

2016

Arrhythmia &Amp; Electrophysiology Review

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This article presents the epidemiology, aetiology and pathophysiology of sudden cardiac death. The modern management of survivors as well as of family members of victims is discussed, as are the relevant recommendations of guidelines prepared by learned societies. KeywordsOut-of-hospital cardiac arrest, sports-related sudden death, sudden cardiac death, sudden unexplained death syndrome Disclosure: The authors have no conflicts of interest to declare.

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Section: Department Of Defense Cardiovascular Death Registry In the Umentioning

confidence: 99%

Section: Department Of Defense Cardiovascular Death Registry In the Umentioning

confidence: 99%

A Clinical Perspective on Sudden Cardiac Death

2016

Arrhythmia &Amp; Electrophysiology Review

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“…We permit some reclassification of falsepositives after initial diagnosis, whereas Wheeler et al 15 17 recent data from a Danish cohort suggests otherwise. 29 We believe that a conservative estimate of relative risk is warranted. To illustrate the impact of this particular design difference, we re-estimated our model by using the higher SCD risk ratio.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of Strategies to Reduce Sudden Cardiac Death in Young Athletes

et al. 2012

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OBJECTIVE: There is controversy about appropriate methods to reduce sudden cardiac death (SCD) in young athletes, but there is limited evidence on costs or consequences of alternative strategies. The objective of this study was to evaluate the cost-effectiveness of adding electrocardiogram (ECG) screening to the currently standard practice of preparticipation history and physical examination (H&P) to reduce SCD. METHODS: Decision analysis modeling by using a societal perspective, with annual Markov cycles from age 14 until death. Three screening strategies were evaluated: (1) H&P, with cardiology referral if abnormal (current standard practice); (2) H&P, plus ECG after negative H&P, and cardiology referral if either is abnormal; and (3) ECG only, with cardiology referral if abnormal. Children identified with SCD-associated cardiac abnormalities were restricted from sports and received cardiac treatment. Main outcome measures were costs of screening and treatment, quality-adjusted life years (QALYs), and premature deaths averted. RESULTS: Relative to strategy 1, incremental cost-effectiveness is $68 800/QALY for strategy 2 and $37 700/QALY for strategy 3. Monte Carlo simulation revealed the chance of incremental cost-effectiveness compared with strategy 1 was 30% for strategy 2 and 66% for strategy 3 (assumed willingness to pay ≤$50 000/QALY). Compared with strategy 1, strategy 2 averted 131 additional SCDs at $900 000 per case, and strategy 3 averted 127 SCDs at $600 000 per case. CONCLUSIONS: Under a societal willingness to pay threshold of $50 000/QALY, adding ECGs to current preparticipation evaluations for athletes is not cost-effective, with costs driven largely by false-positive findings.

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“…Furthermore, it has been reported to be an important cause of sports-related sudden cardiac arrest [1]. Although implantable cardioverter defibrillator (ICD) therapy is necessary in the secondary prevention after survived cardiac arrest, or sustained ventricular tachyarrhythmias in the patients [2,3], its role for the primary prevention in asymptomatic patients with ARVC with no history of sustained tachyarrhythmias or cardiac arrest remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis on risk stratification of malignant ventricular tachyarrhythmic events in arrhythmogenic right ventricular cardiomyopathy

Roh

Jang

Cho

2017

Yeungnam Univ J Med

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Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiomyopathy characterized by predominant right ventricular fibro-fatty replacement, right ventricular dysfunction and ventricular arrhythmias. It is a rare but important cause of sudden cardiac death in children and young adults. A meta-analysis on risk stratification of major ventricular tachyarrhythmic events indicating the need for implantable cardioverter defibrillator therapy in ARVC was performed. Methods: The pubmed database was searched from its inception to May 2015. Of the 433 citations identified, 12 were included in this meta-analysis. Data regarding major ventricular tachyarrhythmic events were retrieved in 817 subjects from the studies. For the variables, a combined odds ratio (OR) was calculated using a fixed-effects meta-analysis. Results: Extensive right ventricular dysfunction (OR, 2.44), ventricular late potential (OR, 1.66), inducible ventricular tachyarrhythmia during electrophysiology study (OR, 3.67), non-sustained ventricular tachycardia (OR, 3.78), and history of fatal event/sustained VT (OR, 5.66) identified as significant risk factors (p<0.0001). Conclusion:This meta-analysis shows that extensive right ventricular dysfunction, ventricular late potential, inducible ventricular tachyarrhythmia during electrophysiological study, non-sustained ventricular tachycardia, and history of sustained ventricular tachycardia/fibrillation are consistently reported risk factors of major ventricular tachyarrhythmic events indicating implantable cardioverter defibrillator therapy in patients with ARVC.

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Incidence and etiology of sports-related sudden cardiac death in Denmark—Implications for preparticipation screening

Cited by 208 publications

References 16 publications

A Clinical Perspective on Sudden Cardiac Death

A Clinical Perspective on Sudden Cardiac Death

Economic Evaluation of Strategies to Reduce Sudden Cardiac Death in Young Athletes

Meta-analysis on risk stratification of malignant ventricular tachyarrhythmic events in arrhythmogenic right ventricular cardiomyopathy

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