Sports-related Sudden Cardiac Arrest Research Articles

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

ObjectiveEvidence 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...

MP-453090-1 SPORTS RELATED SUDDEN CARDIAC ARREST IN CANADA: INCIDENCE AND SURVIVAL

Sports-related sudden cardiac arrest (SCA) is widely recognized in young competitive athletes, yet recent studies have shown it occurs most frequently in middle-aged, recreational athletes. Few studies have comprehensively described the incidence of sports-related SCA in the general population. To describe sports-related SCA events in 3 Canadian Provinces: Ontario, Saskatchewan, and British Columbia, with a combined estimated population of 7.5 million. C-SCAN is a multidisciplinary network measuring the scope of SCA across Canada. We conducted a cohort study using Emergency Medical Services records from consecutive SCAs ages 18-85 that had no obvious cause, were treated, and occurred during or ≤1 hour after sports activity. The intensity level for each sport was assigned an estimated metabolic equivalent (MET). We defined moderate exercise as a MET score of 3-5.9 and vigorous as ≥6. A total of 14,130 SCAs occurred between Jan 1, 2016 - Dec 31, 2020, of which 272 (1.9%) were sport-related. Most were male (93%; 253/272), with a median age of 60 years [IQR 50, 70]. The overall incidence was 1.2 per 100,000 person-years (95% CI, 1.1-1.3), with males having a 14-fold higher incidence than females 2.3 (95% CI: 2.0-2.6) vs. 0.2 (95% CI: 0.1-0.3) per 100,000 person-years, respectively. SCAs occurred during 35 unique sports (Figure 1); intensity was vigorous (44.9%; 122/272) , moderate (30.5%; 83/272) or uncertain (24.6% ; 67/272). Most took place in recreational facilities (62.1%; 169/272), with high rates of bystander witnessed (73.9%; 201/272) and bystander CPR (79.0%; 215/272). Bystanders applied an AED in 43.4% (118/272) of cases and AED shocks were delivered in 99/118 (84%), when an AED was applied. Median EMS response time was 6 [IQR 5, 9] minutes, with an initial shockable rhythm reported in 51.1% (139/272). Over half of those with known final vital status (52.3%; 134/256) survived to hospital discharge. Sport-specific survival rates were highly variable (Figure 1, Table 1). Almost 30% (74/272) reported symptoms ≤1 hour of sports activity, with chest pain (n=28), shortness of breath (n=18), and dizziness (n=12) being most common. Sports-related SCA occurs infrequently, yet attracts high rates of bystander intervention, resulting in a high proportion of survivors. Data on sport-specific survival and preceding symptoms could help inform risk stratification and public response strategies.Tabled 1Table 1: Characteristics and interventions of sports-related SCAs (n = 272)SportMale cases (n = 253)(n, %)Female cases (n = 19)(n, %)Age (mean, SD)Bystander AED applied (n, %)Survived to hospital discharge (n, %)Hockey43 (17%)0 (0%)56 (12.4)34 (79.1%)31/40 (77.5%)Cycling39 (15.4%)1 (5.3%)63.7 (9.4)4 (10%)17/38 (44.7%)Running/jogging31 (12.3%)3 (15.8%)49.3 (17.1)12 (35.3%)19/30 (63.3%)Ball sports30 (11.9%)3 (15.8%)57 (16.8)16 (48.5%)21/31 (67.7%)Home/gym workout26 (10.3%)2 (10.5%)60.2 (11.6)12 (42.9%)10/27 (37%)Swimming23 (9.1%)4 (21.1%)58.9 (18.2)16 (59.3%)7/27 (25.9%)Racket sports20 (7.9%)0 (0%)65.1 (8.7)9 (45%)14/18 (77.8%)Exercise Class14 (5.5%)5 (26.3%)58.7 (13.2)5 (26.3%)9/17 (52.9%)Winter sports12 (4.7%)0 (0%)64.1 (14.1)7 (58.3%)2/12 (16.7%)Other8 (3.2%)0 (0%)57.2 (17.4)3 (37.5%)3/8 (37.5%)Water sports7 (2.8%)1 (5.3%)55.5 (12.8)0 (0%)1/8 (12.5%)Survival rate calculation includes only those for whom final vital status is known. Open table in a new tab

Sudden Cardiac Arrest During Sports Activity in Older Adults

BackgroundSports 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. ObjectivesIn this study, the authors investigated the prevalence and characteristics of SrSCA among subjects ≥65 years of age in a large U.S. population. MethodsAll 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. ResultsOf 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. ConclusionsAmong 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.

Sports-related sudden cardiac arrest in young adults.

Data on sports-related sudden cardiac arrest (SrSCA) among young adults in the general population are scarce. We aimed to determine the overall SrSCA incidence, characteristics, and outcomes in young adults. Prospective cohort study of all cases of SrSCA between 2012 and 2019 in Germany and Paris area, France, involving subjects aged 18-35 years. Detection of SrSCA was achieved via multiple sources, including emergency medical services (EMS) reporting and web-based screening of media releases. Cases and aetiologies were centrally adjudicated. Overall, a total of 147 SrSCA (mean age 28.1 ± 4.8 years, 95.2% males) occurred, with an overall burden of 4.77 [95% confidence interval (CI) 2.85-6.68] cases per million-year, including 12 (8.2%) cases in young competitive athletes. While bystander cardiopulmonary resuscitation (CPR) was initiated in 114 (82.6%), automated external defibrillator (AED) use by bystanders occurred only in a minority (7.5%). Public AED use prior to EMS arrival (odds ratio 6.25, 95% CI 1.48-43.20, P = 0.02) was the strongest independent predictor of survival at hospital discharge (38.1%). Among cases that benefited from both immediate bystander CPR and AED use, survival rate was 90.9%. Coronary artery disease was the most frequent aetiology (25.8%), mainly through acute coronary syndrome (86.9%). Sports-related sudden cardiac arrest in the young occurs mainly in recreational male sports participants. Public AED use remains disappointingly low, although survival may reach 90% among those who benefit from both bystander CPR and early defibrillation. Coronary artery disease is the most prevalent cause of SrSCA in young adults.

NewsCAP: Survival is improving in sports-related sudden cardiac arrest.

AJN, American Journal of Nursing: May 2022 - Volume 122 - Issue 5 - p 14 doi: 10.1097/01.NAJ.0000830704.51753.cf

EP News: Allied Professionals

Using data from the Paris-Sudden Death Expertise Center, which maintains prospective registries of sudden cardiac arrest (SCA) within the greater Paris area, Karam et al (J Am Coll Cardiol 2022;79:238–246, PMID 35057909) sought to assess temporal trends in the incidence, management, and outcome of sports-related sudden cardiac arrest (SrSCA). SrSCA was defined as a sudden, unexpected pulseless event occurring during sports or within 1 hour of sports end. Included were subjects 18–75 years of age, and young competitive athletes were considered those 18–35 years old who engaged in organized team or individual sports.

Summary and comment of "Evolution of incidence, management and outcomes over time in sports-related sudden cardiac arrest"

“...O exercício físico de baixa intensidade é considerado muito seguro e os seus efeitos benéficos são realçados em todas idades e em quase todas as situações. Por outro lado, o exercício físico intenso e o stress associado à competição são gatilhos que podem originar a PCS ou o enfarte do miocárdio... Duas outras importantes conclusões sobressaíram desta análise: a incidência de PCS permaneceu relativamente estável ao longo do tempo em que o estudo decorreu, enquanto a mortalidade diminuiu significativamente devido ao aumento na taxa de sobrevivência (3 vezes), consequência da melhoria das medidas de socorro e do uso muito mais frequente do desfibrilador automático externo (18 vezes mais)... Os autores salientam, a propósito das medidas de prevenção deste evento, as duas estratégias fundamentais: triagem sistemática dos praticantes através do exame médico-desportivo e das medidas de socorro e de reanimação (RCR) imediatas no terreno...”

Evolution of Incidence, Management, and Outcomes Over Time in Sports-Related Sudden Cardiac Arrest

BackgroundMajor efforts have been made to reduce the burden of sports-related sudden cardiac arrest (SrSCA). The extent to which the incidence, management, and outcomes changed over time has not been investigated. ObjectivesThe purpose of this study was to assess temporal trends in SrSCA incidence, management, and survival. MethodsUsing data from the French National Institute of Health and Medical Research, we evaluated the evolution of incidence, prehospital management, and survival at hospital discharge of SrSCA among subjects aged 18 to 75 years, over 6 successive 2-year periods between 2005 and 2018. ResultsAmong the 377 SrSCA, 20 occurred in young competitive athletes (5.3%), whereas 94.7% occurred in middle-aged recreational sports participants. Comparing the last 2-year to the first 2-year period, SrSCA incidence remained stable (6.24 vs 7.00 per million inhabitants/y; P = 0.51), with no significant differences in patients' mean age (46.6 ± 13.8 years vs 51.0 ± 16.4 years; P = 0.42), sex (men 94.7% vs 95.2%; P = 0.99), and history of heart disease (12.5% vs 15.9%; P = 0.85). However, frequency of bystander cardiopulmonary resuscitation and public automated external defibrillator use increased significantly (34.9% vs 94.7%; P < 0.001 and 1.6% vs 28.8%; P = 0.006, respectively). Survival to hospital discharge improved steadily, reaching 66.7% in the last study period compared with 23.8% in the first (P < 0.001). ConclusionsIncidence of SrSCA remained relatively stable over time, suggesting a need for improvement in screening strategies. However, major improvements in on-field resuscitation led to a 3-fold increase in survival, underlining the value of public education in basic life support that should serve as an example for SCA in general.

Cardiovascular Risk Assessment after COVID-19 Infection before Resuming Sports Activities - Practical Flowchart and Meta-Analysis

Background: The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. There is an urgent need for evidence-based criteria to ensure patient safety before resuming exercise. Objective: To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection. Methods: We searched the Medline and Cochrane databases for articles on the prevalence of acute myocardial injury associated [...]

The Role of Bystander-initiated Basic Life Support in Sports-related Sudden Cardiac Arrest: A Systematic Review

Background: Sudden cardiac arrest is the leading medical cause of death amongst athletes and a common cause of death during exercise. The provision of cardiopulmonary resuscitation (CPR) and automatic external defibrillator (AED) use by bystanders can greatly improve survival outcomes in sudden cardiac arrest. However, the effectiveness of these interventions within exertional settings requires further investigation.&#x0D; Objective: To evaluate the role of bystander-initiated CPR and AED use on survival outcomes amongst sports-related sudden cardiac arrest (SrSCA).&#x0D; Methods: Several databases and grey literature sources were queried from inception until November 2020 using a comprehensive search strategy. Abstract screening, full-text review, and data extraction of eligible studies were conducted independently by two reviewers. SrSCA was defined as a cardiac arrest which occurred during (or within 1-hour of) physical activity, sport, or exercise. Bystander CPR and AED rates, as well as appropriate survival outcomes, were extracted from each study, and overall summary measures were calculated.&#x0D; Results: A total of 2,850 unique records were identified, with 176 articles selected for full-text review, of which 32 studies were included in this review. The median rate of bystander CPR and AED use was 75% and 24%, respectively. Survival to hospital discharge ranged from 11%-93%, with a median rate of 33%.&#x0D; Conclusions: Majority of SrSCAs received bystander CPR and achieved a high rate of survival to hospital discharge, yet AED use was low. These findings encourage layperson education in basic life support, the availability of AEDs in athletic facilities, and emergency action plans to ensure timely resuscitation.

Incidence of recreational sports-related sudden cardiac arrest in participants over age 12 in a general African population

BackgroundThe incidence of sports-related sudden cardiac arrest (SrSCA) in sub-Saharan Africa is unknown.ObjectiveTo determine the incidence of sudden cardiac arrest (SCA) in non-competitive athletes in an urban population of Cameroon,...

Sports-Related Sudden Cardiac Arrest in Germany

BackgroundKnowledge about causes of sports-related sudden cardiac arrest (SrSCA) may influence national strategies to prevent such events. Therefore, we established a prospective registry on SrSCA to estimate the incidence and in particular describe the etiologies of SrSCA in the general population in Germany. MethodsThe registration of SrSCA based upon 4 pillars: a web-based platform to record SrSCA cases in competitive and recreational athletes, media-monitoring, cooperation with the German Resuscitation Registry, and 15 institutes of forensic medicine. ResultsAfter an observation period of 6 years, a total of 349 cases was recorded (mean age 48.0 ± 12.7 years); 109 subjects survived. Most of the cases occurred during nonelite competitive or recreational sports. Bystander cardiopulmonary resuscitation (CPR) was initiated in 262 cases (75%); however, rhythm analysis and defibrillation (if indicated) was mainly performed by medical services. In patients ≤ 35 years of age, premature coronary artery disease (CAD) and sudden arrhythmic death syndrome (SADS) prevailed, followed by myocarditis. In athletes ≥ 35 years of age, CAD predominated. ConclusionsCountry-specific registries are necessary to define the national screening and prevention strategy optimally. In Germany, premature CAD, SADS, and myocarditis are the leading causes of SrSCA in young athletes, reinforcing the great disparity of the prevalence of cardiac diseases among different countries. Extension of on-site SCD-prevention campaigns, with training of CPR and explanation of the efficient use of automated external defibrillators (AEDs), may decrease the burden of SrSCD.

4250Sports-related sudden cardiac arrest in Germany

Abstract Background Knowledge about causes of sports-related sudden cardiac arrest (SrSCA) may influence national strategies to prevent such events. Purpose We established a prospective registry on SrSCA to estimate the incidence and in particular describe the etiologies of SrSCA in the general population in Germany. Methods The registration of SrSCA based upon 4 pillars: a) a web-based platform to record SrSCA cases in competitive and recreational athletes, b) media-monitoring and c) a cooperation with the German Resuscitation Registry as well as d) 15 institutes of forensic medicine. Results After an observation period of 6 years, a total of 349 cases was recorded (mean age 48.0±12.7 years) of which 109 subjects survived. Most of the cases occurred during non-elite competitive or recreational sports. Bystander cardiopulmonary resuscitation (CPR) was initiated in 262 cases (75%), however rhythm analysis and defibrillation (if indicated) was mainly performed by medical service. In subjects ≤35 years, premature coronary artery disease (CAD) and sudden arrhythmic death syndrome (SADS) prevailed, followed by myocarditis. In athletes ≥35 years, CAD predominated. Conclusion The prevalence of cardiac pathologies in young athletes seems to vary across different countries. CAD represents the most common cause of SrSCA in the general population of Germany, highlighting the need for a targeted cardiovascular risk evaluation including young athletes. Public education on basic life support including the appropriate use of an automated external defibrillator (AED) may further decrease the burden of sudden cardiac death. Acknowledgement/Funding Funding from the German Heart Foundation

Does occurrence during sports affect sudden cardiac arrest survival?

ObjectivesA higher survival rate was observed in Sudden Cardiac Arrest (SCA) occurring during sports activities, although the underlying mechanisms remain unclear. We tested the hypothesis that better initial management, rather than sports per se, may account for the observed better outcomes during sports activities. MethodsData was taken between May 2011 and March 2016 from a prospective ongoing registry that includes all SCA in Paris and suburbs (6.7 million inhabitants). Sports-related SCA (i.e. SCA occurring during sport activities or within one hour of cessation of the activity) were identified. ResultsOver the study period, 13,400 SCA occurred, of which 154 were sports-related (median age: 51.2 years, 96.1% males). At discharge, sports activity was associated with an 8-times higher survival rate (39.7% vs. 5.1%, P < 0.001). Logistic regression showed that after considering potential confounders, including age, gender, SCA location, witness presence, time to response, and initial shockable rhythm, occurrence of SCA during sports was associated with a higher survival rate (OR 1.77, 95% CI 1.14–2.74, P = 0.01). However, after further adjustment for initial basic life support, i.e. bystander CPR and AED use, there was no association between sports setting and survival at hospital discharge (OR 1.43, 95% CI 0.91–2.23, P = 0.12). ConclusionSports-related SCA is a rare event, with an 8-times higher survival rate compared to non-sports-related SCA. Better initial management, including bystander CPR and AED use, rather than sports per se, mainly accounts this difference. This highlights the major importance of population education to basic life support in improving SCA outcome.

Coronary artery disease underlies most sports-related sudden cardiac arrest in the general population

Existing studies on sports-related sudden cardiac arrest (SCA) have focused principally on young competitive athletes. There is limited information on sports-related SCA in the general population. We sought to determine the burden, characteristics and etiology of SCA during sports activity in adults. Cases occurring during sports activity were compared to those unrelated to sports regarding characteristics and previous medical history. All cases of SCA occurring in the area (6.6 million inhabitants) were prospectively ascertained over a five-year period in this ongoing multicentre study. Data from all SCA during sports activity in either a competitive or recreational setting were analyzed. From May 2011 to May 2016, 3028 patients fulfilling criteria for SCA were admitted alive to hospital. Out of these, 138 (4.6%) SCA occurred during sports. The 3 most common sport activities during the SCA event were running (34.5%), cycling (14.4%) and soccer (8.6%). Sports-related SCA cases were younger (mean age: 52.7 ± 15.6 vs. 59.6 ± 15.6 years old, P < 0.001), more likely to be male (90.6 vs. 71.9%, P < 0.001), had lower cardiovascular risk factors (≥ 1 CVRF, 72.1 vs. 81.4%, P = 0.012), higher rate of bystander cardiopulmonary resuscitation (84.1 vs. 62.9%, P < 0.001) and higher proportion of ventricular fibrillation at EMS arrival (73.9 vs. 51.1%, P < 0.001) compared to other SCA. Among cases admitted alive to hospital with identified cause of SCA (71%), coronary artery disease (72.4%) was the main cardiovascular abnormality identified, mostly acute coronary syndrome (62.2%). Prior to SCA event, 22 cases (15.9%) were known to have heart disease, including CAD (5.8%) and 77 (66.4%) others presented with ≥ 1 CVRF. SCA during sports mostly concerns middle-aged men, with CAD being the frequent underlying cause (up to 75%). These results provide information to enhance sport preparticipation screening.

Risk Factors of Sudden Cardiac Death in the Young: Multiple-Year Community-Wide Assessment.

Prevention of sudden cardiac arrest (SCA) in the young remains a largely unsolved public health problem, and sports activity is an established trigger. Although the presence of standard cardiovascular risk factors in the young can link to future morbidity and mortality in adulthood, the potential contribution of these risk factors to SCA in the young has not been evaluated. We prospectively ascertained subjects who experienced SCA between the ages of 5 and 34 years in the Portland, Oregon, metropolitan area (2002-2015, catchment population ≈1 million). We assessed the circumstances, resuscitation outcomes, and clinical profile of subjects who had SCA by a detailed evaluation of emergency response records, lifetime clinical records, and autopsy examinations. We specifically evaluated the association of standard cardiovascular risk factors and SCA, and sports as a trigger for SCA in the young. Of 3775 SCAs in all age groups, 186 (5%) occurred in the young (mean age 25.9±6.8, 67% male). In SCA in the young, overall prevalence of warning signs before SCA was low (29%), and 26 (14%) were associated with sports as a trigger. The remainder (n=160) occurred in other settings categorized as nonsports. Sports-related SCAs accounted for 39% of SCAs in patients aged ≤18, 13% of SCAs in patients aged 19 to 25, and 7% of SCAs in patients aged 25 to 34. Sports-related SCA cases were more likely to present with shockable rhythms, and survival from cardiac arrest was 2.5-fold higher in sports-related versus nonsports SCA (28% versus 11%; P=0.05). Overall, the most common SCA-related conditions were sudden arrhythmic death syndrome (31%), coronary artery disease (22%), and hypertrophic cardiomyopathy (14%). There was an unexpectedly high overall prevalence of established cardiovascular risk factors (obesity, diabetes mellitus, hypertension, hyperlipidemia, smoking) with ≥1 risk factors in 58% of SCA cases. Sports was a trigger of SCA in a minority of cases, and, in most patients, SCA occurred without warning symptoms. Standard cardiovascular risk factors were found in over half of patients, suggesting the potential role of public health approaches that screen for cardiovascular risk factors at earlier ages.

P4935Coronary artery disease underlies most sports-related sudden cardiac arrest in the general population

P4935Coronary artery disease underlies most sports-related sudden cardiac arrest in the general population

4837Coronary findings in sports-related compared to non sports-related sudden cardiac arrest

4837Coronary findings in sports-related compared to non sports-related sudden cardiac arrest

Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities

We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities). This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P < .0001). Patients with SCA in sports facilities were younger (42.1 vs 51.3 years, P < .0001) and less frequently had known cardiovascular diseases (P < .0001). The events were more often witnessed (99.8% vs 84.9%, 0.0001), and bystander cardiopulmonary resuscitation was more frequently initiated (35.4% vs 25.9%, P = .003). Delays of intervention were significantly shorter when SCA occurred in sports facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P < .0001). Better survival in sports facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134). Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival.

Abstract 17127: Sports-Related Sudden Cardiac Arrest: Comparison of Survival Outcomes in Europe versus the United States

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.