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Markers and trigger mechanisms of sudden cardiac death

Exercise and sports activity
  • F. Furlanello
  • R. Bettini
  • G. Vergara
  • A. Bertoldi
  • M. Del Greco
  • G. B. Durante
  • L. Frisanco
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 110)

Abstract

Exertion-related cardiac arrest and sudden death may happen both in cardiac patients and in subjects without evident heart disease. This latter group includes young athletes who are also competitive and at a high level of sports activity with asymptomatic cardiopathy [1, 2, 3, 4, 5, 6, 7, 8]. Exertion and sports activity-related cardiac arrest is typically a primary arrhythmic event [9] due to electrical destabilization of underlying heart disease or to primary arrhythmic disorders. Several reports have indicated that there is a small correlation between vigorous exercise and cardiac arrest (CA) — sudden cardiac arrhythmic death (SCAD) in the general population. This correlation ranges from 9 to 17% of all sudden death [10, 11, 12] and is about 11% of patients resuscitated from out-of hospital cardiac arrest due to ventricular fibrillation [9]. However, in young athletes, a cardiac arrest/ SCAD is normally sports activity-related [1, 8]. In fact, serious arrhythmic patterns are possible in athletes during or immediately after athletic activity (post-exertion vulnerable period). These manifestations may cause critical symptoms and/or haemodynamic repercussions which include presyncope, syncope, hyperkinetic or hypokinetic cardiac arrest, aborted sudden death which, if not resuscitated, may lead to sudden death [2].

Keywords

Cardiac Arrest Sudden Death Ventricular Tachycardia Sudden Cardiac Death Sport Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Reference

  1. 1.
    Furlanello F, Bettini R, Cozzi F, Del Favero A, Disertori M, Vergara G, Durante GB, Guarnerio M, Inama G, Thiene GL: Ventricular arrhythmias and sudden death in athletes. Ann NY Acad Sci 1984; 253 - 279.Google Scholar
  2. 2.
    Furlanello F, Vecchiet L, Bettini R, Cozzi F, Vergara G, Antolini R, Resina A: Arrhythmias in athletes. In: Cosin J. Bayés de Luna AJ, Garcia Civera R, Cabadés A (eds),: Cardiac Arrhythmias. Diagnosis and Treatment, Pergamon Press 1988; 457 - 467.Google Scholar
  3. 3.
    Furlanello F, Bettini R, Bertoldi A, Vergara G, Visonà L, Durante GB, Inama G, Frisanco L, Antolini R, Zanuttini D: Arrhythmias patterns in arrhythmogenic right ventricular dysplasia athletes. Eur Heart J 1989; 10, 16 - 18.PubMedGoogle Scholar
  4. 4.
    Furlanello F, Bettini R, Bertoldi A, Visona L, Vergara G, Cozzi F, Del Greco M, Braito G, Durante GB, Inama G, Antolini R: Malignant Arrhythmias in Athletes. A clinicopathological overview. New trend Arrhyt 1989; in press.Google Scholar
  5. 5.
    Thiene G, Gambino A, Corrado D, Nava A: The pathological spectrum underlying sudden death in athletes. New trend Arrhyt, 1, 1985; 3: 323 - 330.Google Scholar
  6. 6.
    Thiene G, Nava A, Corrado D, Rossi L, Pennelli N: Right Ventricular Cardiomyopathy and Sudden Death in Young People. N Engl J Med 1988; 318, 3: 129 - 133.PubMedCrossRefGoogle Scholar
  7. 7.
    Northcote RJ, Flannigan C, Ballantyne D: Sudden death and Vigorous exercise — a study of 60 deaths associated with squash. Br Heart J 1986; 55: 198.PubMedCrossRefGoogle Scholar
  8. 8.
    Maron BJ, Epstein SE, Roberts WC: Causes of Sudden Death in Competitive Athletes. JACC 1986; 7, 1: 204 - 214.PubMedGoogle Scholar
  9. 9.
    Cobb LA, Weaver WD: Exercise: A Risk for Sudden Death in Patients With Coronary Heart Disease. JACC 1986; 7. 1: 215 - 219.PubMedGoogle Scholar
  10. 10.
    Liberthson RR, Nagel EL, Hirschman JC, Nussenfielf JD, Blackbourne BD, Davis JD: Pathophysiologic observation in prehospital ventricular fibrillation and sudden cardiac death. Circulation 1974; 49: 790 - 798.PubMedGoogle Scholar
  11. 11.
    Kala R, Romo N, Siltanen P, Halonen PI: Physical activity in sudden cardiac death. Adv Cardiol 1978; 25: 27 - 34.PubMedGoogle Scholar
  12. 12.
    Vuoir I, Makarainen M, Jaaskelainen A: Sudden death and physical activity. Cardiology 1978; 63: 287 - 304.CrossRefGoogle Scholar
  13. 13.
    Coplan NL, Gleim GW, Nicholas JA: Exercise and sudden cardiac death. Am Heart J 1988; 115, 1: 207 - 212.PubMedCrossRefGoogle Scholar
  14. 14.
    Waller BF: Exercise-related sudden death in young (age ≤ 30 years) and old (age > 30 years) conditioned subjects. In: Wenger NK (ed), Exercise and the heart. Philadelphia: FA Davis Co. 1985; 9–74.Google Scholar
  15. 15.
    Bayés de Luna, J Guindo Soldevila: Sudden Cardiac Death. Editorial MCR, Barcelona 1989.Google Scholar
  16. 16.
    Rossi L, Thiene G: Arrhythmologic pathology of sudden cardiac death Milano. Casa Editrice Ambrosiana, 1983.Google Scholar
  17. 17.
    Furlanello F, Bettini R, Bertoldi A, Visonà L, Vergara G, Antolini R, Resina A, Vecchiet L: Holter monitoring in sports medicine. JAM 1989; 1, 3, in press.Google Scholar
  18. 18.
    Epstein SE, Maron BJ: Sudden Death and the Competitive Athlete: Perspectives on Preparticipation Screening Studies. JACC 1986; 7, 1: 220 - 230.PubMedGoogle Scholar
  19. 19.
    Weaver WD, Cobb LA, Hallstrom AP: Characteristics of Survivors of Exertion - and Nonexertion - Related Cardiac Arrest: Value of Subsequent Exercise Testing. Am Heart J 1982; 50: 671 - 676.Google Scholar
  20. 20.
    Tavazzi L, Ignone G: Rehabilitation: effect on exercise arrhythmias. Eur. Heart J. 8 (Suppl. D) 1987; 83 - 90.PubMedGoogle Scholar
  21. 21.
    Van Camp SP: Risk of Sudden Death With Exercise. JACC 1986; 8, 4: 991 - 992.PubMedGoogle Scholar
  22. 22.
    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.PubMedCrossRefGoogle Scholar
  23. 23.
    Gibbons LW, Cooper KH, Meyer BM, Ellison RC: The acute cardiac risk of strenuous exercise. JAMA 1980; 244: 1799 - 1801.PubMedCrossRefGoogle Scholar
  24. 24.
    Thompson PD, Funk EJ, Carleton RA, Sturner WQ: Incidence of Death During Jogging in Rhode Island From 1975 Through 1980. JAMA 1982; 247, 18: 2535 - 2538.PubMedCrossRefGoogle Scholar
  25. 25.
    Kannel WB, Belanger A, D'Agostino R, Israel I: Physical activity and physical demand on the job and risk of cardiovascular disease and death: The Framingham Study. Am Heart J, 1986; 112, 4: 820 - 825.PubMedCrossRefGoogle Scholar
  26. 26.
    Yater WM, Traum AH, Brown WG, Fitzgerald RP, Geisler MA, Wilcox BB: Coronary artery disease in men 18 to 39 years of age. Report of 866 cases, 450 with necropsy examinations. Am Heart J, 1948; 36: 334 - 372.PubMedCrossRefGoogle Scholar
  27. 27.
    Lown B: Sudden cardiac death: biobehavioral perspective. Circulation 1987; 76 (Suppl. I): 1-186-196.Google Scholar
  28. 28.
    Kuller LH, Talbott EO, Robinson C: Environmental and psychosocial determinants of sudden death. Circulation 1987; 76 (Suppl.I): 1-177-185.Google Scholar
  29. 29.
    Furlanello F, Vergara G, Bettini R, Disertori M, Inama G, Guarnerio M, Visonà L: Progress in the study of Wolff-Parkinson-White syndrome of the athletes. The transesophageal atrial pacing during bycicle exercise. J Sports Card 1984; 1: 101.Google Scholar
  30. 30.
    Vergara G, Furlanello F, Disertori M, Inama G, Guarnerio M, Bettini R, Cozzi F: Induction of supraventricular tachyarrhythmia at rest and during exercise with transesophageal atrial pacing in the electrophysiological evaluation of asymptomatic athletes with Wolff-Parkinson-White syndrome. Eur Heart J 1988; 9: 1119 - 1125.PubMedGoogle Scholar
  31. 31.
    Keefe DL, Schwartz J, Somberg JC: The substrate and the trigger: The role of myocardial vulnerability in sudden cardiac death. Am Heart J 1987; 113, 1: 218 - 225.PubMedCrossRefGoogle Scholar
  32. 32.
    Vergara G, Bettini R, Inama G, Guarnerio M, Durante GB, Frisanco L, Furlanello F: La malattia aritmogena del ventricolo destro. Cardiologia 88, Ediz. Librex 1988; 638 - 645.Google Scholar
  33. 33.
    Thompson PD, Stern MP, Williams P, Duncan K, Hskell WL, Wood PD: Death During Jogging or Running. JAMA 1979; 242, 12: 1265 - 1267.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1991

Authors and Affiliations

  • F. Furlanello
  • R. Bettini
  • G. Vergara
  • A. Bertoldi
  • M. Del Greco
  • G. B. Durante
  • L. Frisanco

There are no affiliations available

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