Sudden cardiac death in athletes: the Lausanne Recommendations

Abstract

Objectives This study reports on sudden cardiac death (SCD) in sport in the literature and aims at achieving a generally acceptable preparticipation screening protocol (PPSP) endorsed by the consensus meeting of the International Olympie Committee (IOC). Background The sudden death of athletes under 35 years engaged in competitive sports is a well-known occurrence; the incidence is higher in athletes ( ~ 2/1OO000 per year) than in non-athletes (2.5: 1 ), and the cause is cardiovascular in over 90%.Methods A systematic review of the literature identified causes of SCD, sex, age, underlying cardiac disease and the type of sport and PPSP in use. Methods necessary to detect pre-existing cardiac abnormalities are discussed to formulate a PPSP for the Medical Commission of the IOC.Results SCD occurred in 1101 (1966-2004) reported cases in athletes under 35 years, 50% had congenital anatomical heart disease and cardiomyopathies and 10% had early-onset atherosclerotic heart disease. Forty percent occurred in athletes un der 18 years, 33% under 16 years; the female/male ratio was 1 /9. SCD was reported in almost ail sports; most frequently involved were soccer (30%), basketball (25%) and running (15%). The PPSP were of varying quality and content. The IOC consensus meeting accepted the proposed Lausanne Recommendations based on this research and expert opinions (http://multimedia.olympic.org/pdf/en_report_886.pdf). Conclusion SCD occurs more frequently in young athletes, even those under the age of 18 years, than expected and is predominantly caused by pre-existing congenital cardiac abnormalities. Premature atherosclerotic disease forms another important cause in these young adults. A generally acceptable PPSP has been achieved by the IOC's acceptance of the Lausanne Recommendations. Eur J Cardiovasc Prev Rehabil 13:000-000

Tamización cardíaca para prevención de muerte súbita en atletas de representación de la Universidad de Antioquia, Medellín, Colombia

“…El objetivo de este estudio fue describir la prevalencia de condiciones cardiovasculares subyacentes que predisponen a MCS en una muestra de atletas de la Universidad de Antioquia, Medellín, Colombia, utilizando la tamización cardiovascular propuesto por la SCE (6).…”

Measurement of ECG abnormalities and cardiovascular risk classification: a cohort study of primary care patients in the Netherlands

“…15 In addition to the MEANS classification, all ECG patterns were evaluated according to the Lausanne criteria for ECG evaluation, as recommended by the ESC (Appendix 1). 16 …”

The Electrocardiogram in Athletes Revisited

“…18 Recommendations have been published by the ESC, 16 a group of US experts, 19 and recently, by an international group of experts in sports cardiology and sports medicine (Seattle criteria, see Tables 2-4). …”

“…However, event rates, most commonly attributable to hypertrophic cardiomyopathy or atherosclerotic coronary disease, have risen over the past decade among male marathon runners. 14 A mandatory national pre-participation screening strategy with routine electrocardiograms (ECGs) is recommended by the European Society of Cardiology (ESC) 15 and the International Olympic Committee, 16 mainly based on the beneficial results of screening observed in the Veneto region of Italy. 5 The American Heart Association has expressed reservations about the cost-efficiency of this approach, and does not endorse ESC screening.…”