Clinical Characteristics and Emergency Response to Sudden Cardiac Arrest/Death Secondary to Cardiomyopathies in Young Athletes.

BACKGROUND

Cardiomyopathies (CMs) are a leading cause of sudden cardiac arrest and death (SCA/D) among young competitive athletes.

OBJECTIVES

The objective of the study was to describe patient demographics, disease characteristics, circumstances, and resuscitative efforts for athletes with SCA/D related to CMs.

METHODS

This observational study identified cases of SCA/D among young competitive athletes aged ≥11 years old competing in middle school, high school, club, college, or semiprofessional/professional sports, and former athletes (within 1 year of participation) through longitudinal surveillance.

RESULTS

Among cases of athlete SCA/D identified from 2002 to 2023 with sufficient information to determine the etiology of SCA/D, 129/454 (28.4%) were attributed to CMs, including 81 (62.8%) hypertrophic CM, 22 (17.1%) arrhythmogenic CM, and 26 (20.2%) with other CMs. Athletes with SCA/D attributed to CMs spanned a wide age range (11-27 years), with hypertrophic CM cases occurring at the youngest average age compared with arrhythmogenic CM or other CM. A total of 87/129 (67.4%) SCA/D events occurred at a sporting facility. Most SCA/D events occurred during practice/training rather than formal games/competition (74.7% vs 25.3%; P < 0.0001) and across diverse venues including school and community sporting facilities. Survival from SCA related to CMs was reported in 45/129 (34.9%) of athletes. Survivors of SCA were more likely to receive bystander cardiopulmonary resuscitation (97.6% vs 80.6%; P = 0.04) and have on-site automated external defibrillator use (72.4% vs 16.2%; P = 0.0001).

CONCLUSIONS

SCA/D due to CMs in young athletes occurs across a broad age spectrum and at diverse sports settings. These findings inform funding priorities and resource allocation to optimize emergency preparedness for SCA/D in sport.