By Dr. Jonathan Shurlock
Grubic et al. systematically reviewed the available literature exploring exercise-related sudden cardiac arrest (SCA). Studies eligible for inclusion were observational studies which assessed populations with exercise related SCA (defined by out-of-hospital cardiac arrest occurring during or within 1 hour of exercise). Studies were excluded if they did not include data on survival outcomes, and the use of cardiopulmonary resuscitation (CPR) or automated external defibrillator (AED).
The systematic review contained 29 studies with a median sample size of 91. The authors found evidence that the majority of exercise-related SCAs presented as shockable cardiac arrest rhythms (median 78%, IQR 62%-86%), in middle-aged (median: 51, IQR: 39-56 years) men (median 92%, IQR 86%-96%).
Furthermore, the pooled data demonstrated initiation of bystander CPR in a majority of cases (median 71%, IQR: 59%-87%), whereas bystander AED use was only demonstrated in 31% of cases (IQRL 19%-42%). Of the available studies, 19 reported percentage survival to hospital discharge; median 32% (IQR 24%-49%). For those studies which further assessed the relationship between bystander intervention and survival, a positive association was demonstrated.
Grubic N, Hill B, Phelan D, et al Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. British Journal of Sports Medicine Published Online First: 01 December 2021. doi: 10.1136/bjsports-2021-104623