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. 2024 Mar 8;58(5):255-260.
doi: 10.1136/bjsports-2023-107357.

Causes of sudden cardiac arrest and death and the diagnostic yield of sport preparticipation screening in children

Francesca Graziano  1   2 , Maurizio Schiavon  3 , Alberto Cipriani  1 , Francesco Savalla  3 , Monica De Gaspari  1 , Barbara Bauce  1 , Stefania Rizzo  1 , Chiara Calore  1 , Gaetano Thiene  1 , Stefano Paiaro  3 , Cristina Basso  1 , Alessandro Zorzi  4
Affiliations

Causes of sudden cardiac arrest and death and the diagnostic yield of sport preparticipation screening in children

Francesca Graziano et al. Br J Sports Med. .

Abstract

Objective: Evidence on the increased risk of sports-related sudden cardiac arrest and death (SCA/D) and the potential benefit of cardiovascular preparticipation screening (PPS) in children is limited. We assessed the burden and circumstances of SCA/D and the diagnostic yield of cardiovascular PPS in children aged 8-15 years.

Methods: Data on the incidence and causes of SCA/D from 2011 to 2020 were obtained from the Veneto region (Italy) sudden death registry, hospital records and local press. During the same period, we assessed the results of annual PPS in 25 251 young competitive athletes aged 8-15 years who underwent 58 185 evaluations (mean 2.3/athlete) in Padua, Italy.

Results: Over 10 years, 26 SCA/D occurred in children aged 8-15 years in the Veneto region: 6 in athletes (incidence 0.7/100 000/year, all ≥12 years) versus 20 in non-athletes (0.7/100 000/year, 17/20 ≥12 years). In total, 4/6 athletes versus 1/20 non-athletes survived. The cause of SCA/D remained unexplained in four athletes and in nine non-athletes. No athlete suffered SCA/D from structural diseases potentially identifiable by PPS. The incidence of SCA/D in athletes and non-athletes was 0.2/100 000/year in the 8-11 years group versus 1.3/100 000/year in the 12-15 years group. PPS identified 26 new diagnoses of cardiovascular diseases (CVDs) at risk of SCA/D, more often in children ≥12 years old (0.06%/evaluation) than <12 years old (0.02%/evaluation, p=0.02). Among athletes with a negative PPS, two suffered unexplained SCA/D during follow-up, one during exercise.

Conclusions: In children aged 8-15 years, the incidence of SCA/D and the yield of PPS for identifying at-risk CVD were both substantially higher in those ≥12 years, suggesting that systematic PPS may be more useful beyond this age.

Keywords: Athletes; Pediatrics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Causes of sudden cardiac death in the Veneto region of Italy in children aged 8–15 years. CPVT, catecholaminergic polymorphic ventricular tachycardia; SCD, sudden cardiac death.
Figure 2
Figure 2
Incidence of sudden cardiac death (SCD) and sudden cardiac arrest (SCA) with survival for 100 000 persons in the overall population, athletes and non-athletes, according to age group.
Figure 3
Figure 3
Diagnostic rate of preparticipation screening for detection of cardiovascular diseases at risk of sudden cardiac death according to the age of the athlete at the time of evaluation.
See this image and copyright information in PMC

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