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Physical activity as a trigger of sudden cardiac arrest: The Oregon Sudden Unexpected Death Study

Published:January 18, 2008DOI:https://doi.org/10.1016/j.ijcard.2007.10.024

      Abstract

      Background

      Sudden cardiac arrest (SCA) is a significant public health problem and better understanding of triggers could enhance prevention. Vigorous physical activity has been suggested as a prominent trigger but has not been well-evaluated in the general population. We performed a community-based study to analyze the role of physical activity as a potential trigger of SCA.

      Methods

      Medical records of 1180 subjects who sustained SCA during the ongoing Oregon Sudden Unexpected Death Study (Multnomah County, Oregon, USA; 2002–05) were reviewed. Analysis was limited to first responder and hospital records of patients who experienced witnessed SCA, with information available regarding physical activity immediately prior to SCA. An estimated metabolic equivalent (MET) score was used to classify levels of physical activity.

      Results

      A total of 304 adults met criteria for analysis (mean age 69 years, 67% male). The majority (n=193, 63%) were performing light activities, 51 (17%) subjects were sleeping, 39 (13%) were performing moderate activities, 14 (5%) were performing heavy activities, and 7 (2%) were engaged in sexual activity. Light activities were associated with older age (72 years) and heavy activities with the youngest (51 years, p<0.001). Males were more likely to be involved in heavy activity (93% male) and the sexual activity group was exclusively male (p=0.04).

      Conclusion

      Vigorous physical activity was a potential trigger of SCA in a minority (5%). The vast majority (80%) of subjects were asleep or were performing light activities. The traditional view of SCA triggers may have to be re-visited, with renewed focus on factors such as emotional stress and sleep-related disorders.

      Keywords

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      References

        • Chugh S.S.
        • Jui J.
        • Gunson K.
        • Stecker E.C.
        • John B.T.
        Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. Community.
        J Am Coll Cardiol. 2004; 44: 1268-1275
        • Muller D.
        • Agarwal R.
        • Arntz H.R.
        How sudden is sudden cardiac death?.
        Circulation. 2006; 114: 1146-1150
        • Willich S.N.
        • Maclure M.
        • Mittleman M.
        • Arntz H.R.
        • Muller J.E.
        Sudden cardiac death: support for a role of triggering in causation.
        Circulation. 1993; 87: 1442-1450
        • Thompson P.D.
        • Funk E.J.
        • Carleton R.A.
        • Sturner W.Q.
        Incidence of death during jogging in Rhode Island from 1975 through 1980.
        JAMA. 1982; 247: 2535-2538
        • Albert C.M.
        • Mittleman M.
        • Chae C.U.
        • Lee I.M.
        • Hennekens C.H.
        Triggering of sudden death from cardiac causes by vigorous exertion.
        N Engl J Med. 2000; 343: 1355-1361
        • Siscovick D.S.
        • Weiss N.S.
        • Fletcher R.H.
        • Lasky T.
        The incidence of primary cardiac arrest during vigorous exercise.
        N Engl J Med. 1984; 311: 874-877
        • Eliot R.S.
        • Buell J.C.
        Role of emotions and stress in the genesis of sudden death.
        J Am Coll Cardiol. 1985; 5: 95B-98B
      1. http://www.placenames.com/us/41051/facts/.

        • Ainsworth B.E.
        • Haskell W.L.
        • Whitt M.C.
        Compendium of physical activities: an update of activity codes and MET intensities.
        Med Sci Sports Exerc. 2000; 32: S498-S516
        • Mittleman M.
        • Maclure M.
        • Tofler G.F.
        Triggering of acute myocardial infarction by heavy physical exertion (MIOS).
        N Engl J Med. 1993; 329: 1677-1683
        • Culic Viktor
        • Eterovic D.
        • Miric Dinko
        Meta-analysis of possible external triggers of acute myocardial infarction.
        Int J Cardiol. 2005; 99: 1-8
        • Tofler G.F.
        • Stone P.H.
        • Maclure M.
        Analysis of possible triggers of acute myocardial infarction (The MILIS Study).
        Am J Cardiol. 1990; 66: 22-27
        • Servoss S.J.
        • Januzzi J.L.
        • Muller J.E.
        Triggers of acute coronary syndromes.
        Prog Cardiovasc Dis. 2002; 44: 369-380
        • Tofler G.H.
        • Muller J.E.
        • Stone P.H.
        Modifiers of timing and possible triggers of acute myocardial infarction in the Thrombolysis in Myocardial Infarction phase II (TIMI II) Study Group.
        Am Coll Cardiol. 1992; 20: 1049-1055