Edwards Melanie J, Fothergill Rachael T
Clinical Audit & Research Unit , London Ambulance Service NHS Trust , London , UK.
Open Heart. 2015 Oct 5;2(1):e000281. doi: 10.1136/openhrt-2015-000281. eCollection 2015.
The study aimed to (1) establish the incidence of exercise-related sudden cardiac arrest (SCA) in London, (2) investigate survival from exercise-related SCA and (3) examine factors related to survival.
This retrospective observational study examined 2 years' data from the London Ambulance Service (LAS) cardiac arrest registry for patients in whom resuscitation was attempted following an out-of-hospital cardiac arrest (OHCA), a cardiac cause was presumed and the arrest occurred during or within 1 h of exercise.
The incidence of exercise-related SCA in London was estimated to be 0.6 per 100 000 person-years which equated to 0.5% of all OHCA, and 1.5% of all OHCA with presumed cardiac aetiology and resuscitation attempted. The majority of cases were male and the incidence increased from age 40 years. Just under one-third of patients survived to hospital discharge. Survival in the Utstein comparator group (cases with presumed cardiac aetiology, resuscitation attempted, bystander witnessed and a presenting cardiac rhythm of ventricular fibrillation or tachycardia) was higher at 42%. Survival was significantly associated with initial cardiac rhythm (χ(2)=17.5, df=2, p<0.001) and bystander defibrillation (Fisher's exact test, p<0.05).
Incidence of exercise-related SCA in the general population in London is rare. Survival following exercise-related SCA was considerably higher than survival for all OHCA with presumed cardiac aetiology and resuscitation attempted attended by the LAS during the same period. The major limitation of the study is the likely under identification of cases of exercise-related SCA.
本研究旨在（1）确定伦敦运动相关心脏骤停（SCA）的发生率，（2）调查运动相关SCA的生存率，以及（3）检查与生存相关的因素。
这项回顾性观察研究检查了伦敦救护车服务（LAS）心脏骤停登记处2年的数据，这些数据来自院外心脏骤停（OHCA）后尝试进行复苏的患者，推测为心脏原因导致的骤停，且该骤停发生在运动期间或运动后1小时内。
伦敦运动相关SCA的发生率估计为每10万人年0.6例，相当于所有OHCA的0.5%，以及所有推测为心脏病因且尝试进行复苏的OHCA的1.5%。大多数病例为男性，发病率从40岁开始上升。不到三分之一的患者存活至出院。Utstein比较组（推测为心脏病因、尝试进行复苏、有旁观者目睹且初始心律为室颤或室速的病例）的生存率较高，为42%。生存与初始心律（χ(2)=17.5，自由度=2，p<0.001）和旁观者除颤（Fisher精确检验，p<0.05）显著相关。
伦敦普通人群中运动相关SCA的发生率很低。运动相关SCA后的生存率明显高于同期LAS处理的所有推测为心脏病因且尝试进行复苏的OHCA的生存率。本研究的主要局限性在于可能未充分识别运动相关SCA病例。
