Sudden cardiac death in athletes: the Lausanne Recommendations.
OBJECTIVE
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 Olympic 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 (approximately 2/100,000 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 under 18 years, 33% under 16 years; the female/male ratio was 1/9. SCD was reported in almost all 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).


CONCLUSIONS
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.
Bille
Karin
K
Division of Pediatric Cardiology, University Hospital of Lausanne, Lausanne, Switzerland.
Figueiras
David
D
Schamasch
Patrick
P
Kappenberger
Lukas
L
Brenner
Joel I
JI
Meijboom
Folkert J
FJ
Meijboom
Erik J
EJ
D000293:Adolescent; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D012307:Risk Factors; D013178:Sports Medicine