An Eight Year Review of Exercise-related Cardiac Arrests

Abstract

Introduction: Exercise-related cardiac arrest is uncommon, however it is devastating when it occurs in otherwise healthy adults. This study aims to identify the characteristics of exercise-related cardiac arrest in the study population and estimate the overall survival rate. Materials and Methods: This is a retrospective observational study of exercise-related cardiac arrest in Singapore. Patients with exercise-related out of hospital cardiac arrest (OHCA) were selected from the Cardiac Arrest and Resuscitation Epidemiology (CARE) database, which is a prospective cardiac arrest registry, derived from ambulance records, emergency department and hospital discharge records. Patient characteristics, cardiac arrest circumstances and outcomes were studied. Results: Fifty-five cases of exercise-related cardiac arrests were identified from December 2001 to January 2008. Mean age was 50.9 years with a male predominance of 96.4%. Eighty percent of the exercise-related cardiac arrests were witnessed, however only 58.2% of the patients received bystander cardiopulmonary resuscitation (CPR). The first presenting rhythm was ventricular fibrillation (VF) in 40% of the patients, followed by asystole (38.2%). Of 96.2% of the patients who died from cardiac causes, coronary artery disease was the main etiology for 54%. The 30-day survival rate was 5.5%. Conclusion: We found that exercise-related cardiac arrest causes significant mortality in our community. Increased CPR training among the public, easy access to defibrillators and faster emergency medical service (EMS) response time could improve the outcome of exercise-related cardiac arrests. A comprehensive pre-participation screening for competitive exercises should be outlined for primary prevention of exercise-related cardiac arrest. A better reporting system for exercise-related cardiac arrest is needed. Key words: Sudden death, Survival