School of Medicine, Yale University, New Haven, Connecticut 06520; email:
Krannert Institute of Cardiology, School of Medicine, Indiana University, Indianapolis, Indiana 46202; email:
Annu Rev Med. 2018 Jan 29;69:177-189. doi: 10.1146/annurev-med-041316-090402.
Professional society recommendations to decrease sudden cardiac death in athletes, including eligibility requirements with disqualification for athletes with diagnosed disease as well as preparticipation screening and emergency preparedness, were updated in 2015. The update includes new sections on aortic disease, channelopathies, and sickle cell trait, as well as a change in format from the previous binary yes/no format to the more nuanced and contemporary "class and level of evidence" format. Eighty-four of the 246 recommendations now carry Class II designation-"reasonable," or "may be considered." New language in the document emphasizes counseling as part of the decision process. New data on athletes with implantable cardioverter-defibrillators, and on those with long QT syndrome, have led to a change from blanket restriction of competitive sports participation to a Class IIB "may be considered" recommendation.
专业协会建议减少运动员的心脏性猝死，包括对诊断出疾病的运动员的资格要求和淘汰，以及参赛前筛查和应急准备，这些建议在 2015 年进行了更新。更新内容包括主动脉疾病、通道病和镰状细胞特质等新章节，以及从以前的二进制“是/否”格式更改为更细致和现代的“类别和证据级别”格式。246 条建议中有 84 条现在被指定为 II 类——“合理”或“可以考虑”。文件中的新语言强调了咨询是决策过程的一部分。关于植入式心脏复律除颤器和长 QT 综合征运动员的新数据，导致从全面限制竞技体育参与改为 IIB 类“可以考虑”的建议。
