Catheter Ablation -> Ventricular Arrhythmias -> Quality Measures & Complications D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-196 - Progressive Temporal Improvements In Survival After Sudden Cardiac Arrest During Sports In The General Population (ID 138)

Abstract

Background: Although major efforts have been made over past 2 decades to reduce occurrence of sudden cardiac arrest (SCA) during sports and resultant mortality, through screening strategies and improved on-field resuscitation respectively, the individual impact of these measures has not been evaluated in a temporal fashion.
Objective: To study the incidence and outcomes of sports related SCA over time, especially focusing on recent trends in survival.
Methods: We analyzed the incidence and survival of sports-related SCA in the community through two prospective studies, encompassing all adult SCA occurring in the Paris area (approximately 7 million inhabitants) over two consecutive periods (2005-2010 and 2011-2016). Details of resuscitative measures and survival were systematically analyzed between the two time periods.
Results: Overall, 320 sports-related SCA occurred, including 17 in young competitive athletes (5.3%). Comparing the second to first study period, population sports-SCA incidence remained stable (6.88 vs. 6.87 per million inhabitant per year, P=0.99), and there were no significant differences in victims' mean age (51.6±15.3 vs. 48.6±14.8 years, P=0.08), proportion of males (94.4% vs. 96.2%, P=0.63), or history of heart disease (17.3% vs. 13.9%, P=0.50). Bystander cardiopulmonary resuscitation and automated external defibrillator use were more frequent (80.9% vs. 46.2%, P<0.001 and 11.9% vs. 1.3%, P<0.001, respectively) in the second period. Survival rates to hospital admission and discharge were also higher (85.2% vs. 50.6%, P<0.001, and 43.2% vs. 25.9%, P=0.002, respectively), while in-hospital mortality remained stable (49.3% vs. 48.8%, P=0.87). Mortality from sports-related SCA decreased from 4.3 (95%CI 3.5 to 5.1) to 3.4 (95%CI 2.7 to 4.0) deaths per million inhabitants per year (P<0.001). In the last twenty months of the second study period, survival to hospital discharge approached 60%.
Conclusion: Improvements in on field resuscitation are leading to continuing, progressive improvements over time in survival of sports-related SCA, with figures especially impressive over the latest 2 years. However, incidence has remained stable despite screening strategies.
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