June 27, 2008–Just one in 10 U.S. student-athletes who suffer sudden cardiac arrest (SCA) survives, a new study found.
SCA is the leading cause of death in young athletes and the leading overall cause of death in the United States. Approximately one SCA case occurs every three days in organized youth sports, according to background information with the study.
“Overall, there is pretty poor survival from sudden cardiac arrest in young people,” said study co-author Dr. Kimberly G. Harmon, of the University of Washington Department of Orthopedics and Sports Medicine.
But, there is a trend toward improved survival, Harmon said. “This is probably due to improved access to external automatic defibrillators (AEDs),” she said. “As we study this over the next several years, we are going to find that survival will improve as emergency plans and AEDs become more available and used.”
Access to defibrillators within three to five minutes could save lives, Harmon said. Defibrillation sends an electrical current through the heart, which can start the heart functioning normally again. To accomplish this, there needs to be an AED on site during practices and games, she said.
For the study, published in the June issue of the HeartRhythm Journal, Harmon's group did an online search looking for cases of sudden cardiac death from 2000 to 2006. They found a total of 486 cases in elementary schools, middle schools, high schools and colleges.
The overall survival rate was 11 percent, ranging from 4 percent to 21 percent a year. Of all cases of sudden cardiac death, 83 percent involved males and 17 percent involved females, the researchers found.
“Schools and places where there are large gatherings of people, where there is potentially going to be an arrest, need to have an AED, and an emergency action plan on how to use the AED,” Harmon said.
She noted that in some cases seen in the study, an AED was locked away in a nurse’s office, and no one knew where it was or how to use it.
Harmon thinks all students should be screened for heart problems before being allowed to participate in sports.
Right now, the screening exam includes a medical history and a physical exam, Harmon said. “The controversy now is whether it should include a screening EKG,” she said. “I think there are strong arguments in favor of screening EKGs. A screening EKG will find 90 percent of things that cause sudden cardiac death in kids.”
In Italy, where a screening EKG is mandated for students participating in sports, the incidence of sudden cardiac death has been cut 90 percent, Harmon said.
Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, believes that more needs to be done to prevent and treat sudden cardiac arrest among student-athletes.
“This study highlights the need for better and more uniform screening methods for young individuals participating in athletics, as well as better emergency preparedness and prompt access to defibrillation across the country,” he said.
The American Heart Association issued recommendations in 2007 that address the benefits, limitations, and medical implications of pre-participation screening in high school and college athletics, Fonarow said.
“While many schools and communities are working to increase access to automatic external defibrillators, additional efforts should be considered,” he said.
-Steven Reinberg, HealthDay Reporter (adapted)