PREVENTION OF SUDDEN CARDIAC DEATH IN ATHLETES WITH ARRHYTHMIAS – CURRENT GUIDELINES AND CONTROVERSIES

Authors

DOI:

https://doi.org/10.31435/ijitss.4(48).2025.4384

Keywords:

Sudden Cardiac Death (SCD), Athletes, Arrhythmia, Prevention

Abstract

Purpose: This paper aims to conduct a thorough examination of contemporary studies pertaining to the prophylaxis of unexpected cardiac mortality in athletes presenting with arrhythmic conditions.

Methodology: A thorough and extensive literature review was undertaken utilizing various scientific databases, such as PubMed, Scopus, and Google Scholar. The criteria for selection emphasized clinical trials, systematic reviews, and meta-analyses that examined sudden cardiac death in athletic populations. The studies were assessed for their methodological robustness, relevance, and practical implications, with particular focus on the risk determinants and essential recommendations.

Findings: Early detection and risk stratification are key to preventing SCD in athletes. Individualized preventive strategies, including lifestyle changes, medical therapy, and ICDs, should be led by a multidisciplinary team. Genetic testing can aid in identifying inherited conditions but is mostly limited to specialist centers. Ongoing disparities in access highlight the need for coordinated international action.

Conclusions: Preventing SCD in athletes requires personalized, team-based care and improved access to diagnostics. Wider implementation of genetic testing and harmonized global guidelines are essential to address current gaps and ensure effective prevention.

References

Castelletti, S., Gray, B., Basso, C., Behr, E. R., Crotti, L., Elliott, P. M., Gonzalez Corcia, C. M., D’Ascenzi, F., Ingles, J., Loeys, B., Pantazis, A., Pieles, G. E., Saenen, J., Sarquella Brugada, G., Sanz De La Garza, M., Sharma, S., Van Craenebroek, E. M., Wilde, A., & Papadakis, M. (2022). Indications and utility of cardiac genetic testing in athletes. European Journal of Preventive Cardiology, 29(12), 1582–1591. https://doi.org/10.1093/eurjpc/zwac080

Commotio cordis (cardiac concussion) in a child. A case report. (2022). Archivos Argentinos de Pediatria. https://doi.org/10.5546/aap.2022-02593.eng

D’Ambrosio, P., Claessen, G., Kistler, P. M., Heidbuchel, H., Kalman, J. M., & La Gerche, A. (2024). Ventricular arrhythmias in association with athletic cardiac remodelling. Europace, 26(12), euae279. https://doi.org/10.1093/europace/euae279

Dello Russo, A., Compagnucci, P., Zorzi, A., Cavarretta, E., Castelletti, S., Contursi, M., D’Aleo, A., D’Ascenzi, F., Mos, L., Palmieri, V., Patrizi, G., Pelliccia, A., Sarto, P., Delise, P., Zeppilli, P., Romano, S., Palamà, Z., & Sciarra, L. (2023). Electroanatomic mapping in athletes: Why and when. An expert opinion paper from the Italian Society of Sports Cardiology. International Journal of Cardiology, 383, 166–174. https://doi.org/10.1016/j.ijcard.2023.05.013

Franzos, M. A., Hellwig, L. D., Thompson, A., Wu, H., Banaag, A., Hulsopple, C., Walsh, J., Campagna, J., O’Connor, F. G., Haigney, M., & Koehlmoos, T. (2025). No One Left Behind: Incidence of Sudden Cardiac Arrest and 30-Day Survival in Military Members. The American Journal of Medicine, 138(6), 987–993. https://doi.org/10.1016/j.amjmed.2025.02.003

Katyal, A., Li, C. O. Y., Franciosi, S., & Sanatani, S. (2023). The safety of sports in children with inherited arrhythmia substrates. Frontiers in Pediatrics, 11, 1151286. https://doi.org/10.3389/fped.2023.1151286

Kojima, K., Kato, K., Fujii, Y., Okuyama, Y., Ohno, S., Ozawa, T., Horie, M., & Nakagawa, Y. (2022). Successful Management of a Young Athlete with Type 2 Long QT Syndrome by Genotype-specific Risk Stratification and Bridging Therapy with a Wearable Cardioverter Defibrillator. Internal Medicine, 61(8), 1179–1182. https://doi.org/10.2169/internalmedicine.8093-21

Landry, C. H., Fatah, M., Connelly, K. A., Angaran, P., Hamilton, R. M., & Dorian, P. (2021). Evaluating the 12-Lead Electrocardiogram for Diagnosing ARVC in Young Populations: Implications for Preparticipation Screening of Athletes. CJC Open, 3(4), 498–503. https://doi.org/10.1016/j.cjco.2020.12.011

Mahendran, S., Gupta, I., Davis, J., Davis, A. J., Orchard, J. W., & Orchard, J. J. (2023). Comparison of methods for correcting QT interval in athletes and young people: A systematic review. Clinical Cardiology, 46(9), 1106–1115. https://doi.org/10.1002/clc.24093

Malik, A., Hanson, J., Han, J., Dolezal, B., Bradfield, J. S., Boyle, N. G., & Hsu, J. J. (2023). Sudden cardiac arrest in athletes and strategies to optimize preparedness. Clinical Cardiology, 46(9), 1059–1071. https://doi.org/10.1002/clc.24095

Okorare, O., Alugba, G., Olusiji, S., Evbayekha, E. O., Antia, A. U., Daniel, E., Ubokudum, D., Adabale, O. K., & Ariaga, A. (b.d.). Sudden Cardiac Death: An Update on Commotio Cordis. Cureus, 15(4), e38087. https://doi.org/10.7759/cureus.38087

Patel, N., Pena, C., Nesheiwat, Z., Zafrullah, F., & Eltahawy, E. (2022). Ventricular fibrillation arrest after blunt chest trauma in a 33-year-old man, commotio cordis? BMC Cardiovascular Disorders, 22(1), 252. https://doi.org/10.1186/s12872-022-02689-4

Richard, P., Perron, P.-A., Sylvain-Morneau, J., & Poirier, P. (2024). Insights from coronial recommendations for preventing natural deaths in sport and recreation in Québec, Canada. Frontiers in Public Health, 12, 1389675. https://doi.org/10.3389/fpubh.2024.1389675

Sareban, M., Hergan, K., Covi, P., & Niebauer, J. (2022). Exertional Dyspnea as the Main Symptom in an Adolescent Athlete With Coronary Artery Anomaly – A Case Report. Frontiers in Cardiovascular Medicine, 9, 872608. https://doi.org/10.3389/fcvm.2022.872608

Sarto, P., Zorzi, A., Merlo, L., Vessella, T., Pegoraro, C., Giorgiano, F., Graziano, F., Basso, C., Drezner, J. A., & Corrado, D. (2023). Value of screening for the risk of sudden cardiac death in young competitive athletes. European Heart Journal, 44(12), 1084–1092. https://doi.org/10.1093/eurheartj/ehad017

Sawczuk, D., Gać, P., Poręba, R., & Poręba, M. (2023). The Prevalence of Cardiovascular Diseases in Paralympic Athletes. Healthcare, 11(7), 1027. https://doi.org/10.3390/healthcare11071027

Scarà, A., Sciarra, L., Russo, A. D., Cavarretta, E., Palamà, Z., Zorzi, A., Brancati, F., Compagnucci, P., Casella, M., Novelli, V., Patrizi, G., & Delise, P. (2025). Brugada Syndrome in Sports Cardiology: An Expert Opinion Statement of the Italian Society of Sports Cardiology (SICSport). The American Journal of Cardiology, 244, 9–17. https://doi.org/10.1016/j.amjcard.2025.02.031

Schmidt, T., Bjarnason-Wehrens, B., Zacher, J., Predel, H.-G., & Reiss, N. (2022). Sports, Myocarditis and COVID-19: Diagnostics, Prevention and Return-to-play Strategies. International Journal of Sports Medicine, 43(13), 1097–1105. https://doi.org/10.1055/a-1810-5314

Seely, K. D., Crockett, K. B., & Nigh, A. (2023). Sudden cardiac death in a young male endurance athlete. Journal of Osteopathic Medicine, 123(10), 461–465. https://doi.org/10.1515/jom-2023-0097

Wilson, M. G. (b.d.). IOC Manual of Sports Cardiology.

Zorzi, A., D’Ascenzi, F., Andreini, D., Castelletti, S., Casella, M., Cavarretta, E., Cipriani, A., Compagnucci, P., Delise, P., Russo, A. D., Graziano, F., Palamà, Z., Pelliccia, A., Sarto, P., Corrado, D., & Sciarra, L. (2023). Interpretation and management of premature ventricular beats in athletes: An expert opinion document of the Italian Society of Sports Cardiology (SICSPORT). International Journal of Cardiology, 391. https://doi.org/10.1016/j.ijcard.2023.131220

Zujko, K., & Małek, Ł. A. (2022). How to Unmask Hidden Cardiovascular Diseases through Preparticipation Screening in Master Athletes? Reviews in Cardiovascular Medicine, 23(12), 405. https://doi.org/10.31083/j.rcm2312405

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Published

2025-12-30

How to Cite

PREVENTION OF SUDDEN CARDIAC DEATH IN ATHLETES WITH ARRHYTHMIAS – CURRENT GUIDELINES AND CONTROVERSIES. (2025). International Journal of Innovative Technologies in Social Science, 5(4(48). https://doi.org/10.31435/ijitss.4(48).2025.4384