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In JACC. Clinical electrophysiology

BACKGROUND : Sports activity among older adults is rising, but there is a lack of community-based data on sports-related sudden cardiac arrest (SrSCA) in the elderly.

OBJECTIVES : In this study, the authors investigated the prevalence and characteristics of SrSCA among subjects ≥65 years of age in a large U.S.

METHODS : All out-of-hospital sudden cardiac arrests (SCAs) were prospectively ascertained in the Portland, Oregon, USA, metro area (2002-2017), and Ventura County, California, USA (2015-2021) (catchment population ∼1.85 million). Detailed information was obtained for SCA warning symptoms, circumstances, and lifetime clinical history. Subjects with SCA during or within 1 hour of cessation of sports activity were categorized as SrSCA.

RESULTS : Of 4,078 SCAs among subjects ≥65 years of age, 77 were SrSCA (1.9%; 91% men). The crude annual SrSCA incidence among age ≥65 years was 3.29/100,000 in Portland and 2.10/100,000 in Ventura. The most common associated activities were cycling, gym activity, and running. SrSCA cases had lower burden of cardiovascular risk factors (P = 0.03) as well as comorbidities (P < 0.005) compared with non-SrSCA. Based on conservative estimates of community residents ≥65 years of age who participate in sports activity, the SrSCA incidence was 28.9/100,000 sport participation years and 18.4/100,000 sport participation years in Portland and Ventura, respectively. Crude survival to hospital discharge rate was higher in SrSCA, but the difference was nonsignificant after adjustment for confounding factors.

CONCLUSIONS : Among free-living community residents age ≥65 years, SrSCA is uncommon, predominantly occurs in men, and is associated with lower disease burden than non-SrSCA. These results suggest that the risk of SrSCA is low, and probably outweighed by the high benefit of exercise.

Holmstrom Lauri, Chugh Harpriya S, Uy-Evanado Audrey, Sargsyan Arayik, Sorenson Chad, Salmasi Shiva, Norby Faye L, Hurst Sean, Young Christopher, Salvucci Angelo, Jui Jonathan, Reinier Kyndaron, Chugh Sumeet S

2022-Nov-11

elderly, epidemiology, screening, sports activity, sudden cardiac death