J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119 DOI 10.1007/s10840-014-9877-z
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Special Abstract issue for the 10th Congress of the European Cardiac Arrhythmia Society (ECAS) March 23–25, 2014 Munich, Germany Guest Editor: Prof. Samuel Lévy, MD Aix-Marseille Université, Marseille, France INVITATION PROGRAM AT A GLANCE 10th Annual Congress of the European Cardiac Arrhythmia Society ECAS 2014 ORAL ABSTRACT SESSIONS 1–4 Sunday, March 23, 2014, 10:30 AM–12:00 PM Oral Abstract Session 1: Risk factors, epidemiology and prevention of sudden cardiac death Oral Abstract Session 2: Oral anticoagulants for stroke prevention in atrial fibrillation (AF) Oral Abstract Session 3: Pharmacological and non-pharmacological management of AF Oral Abstract Session 4: Mechanisms of cardiac arrhythmias ECAS 2014 ORAL ABSTRACT SESSIONS 5–8 Monday, March 24, 2014, 10:30 AM–12:00 PM Oral Abstract Session 5: AF Ablation techniques and prevention of complications Oral Abstract Session 6: Efficacy and potential complications of ICD Therapy Oral Abstract Session 7: Genetic aspects of cardiac arrhythmias Oral Abstract Session 8: Issues in permanent cardiac pacing ECAS 2014 ORAL ABSTRACT SESSIONS 9–12 Tuesday, March 25, 2014, 8:30 AM–10:00 AM Oral Abstract Session 9: Improvement in CRT results Oral Abstract Session 10: Diagnosis and management of VT/VF Oral Abstract Session 11: AF mechanisms and progression Oral Abstract Session 12: Antiarrhythmic drugs therapy ECAS 2014 CHAIRED POSTER SESSION A: PARTS 1 AND 2 Sunday, March 23, 2014, 8:30 AM–12:00 PM Part 1: Supraventricular arrhythmia management and prevention Antiarrhythmic drug therapy Part 2: Issues in cardiac pacing Cardiac Resynchronization Therapy
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Syncope ECAS 2014 CHAIRED POSTER SESSION B: PARTS 1 AND 2 Sunday, March 23, 2014, 2:00 PM–5:30 PM Part 1: Ablation of atrial fibrillation (AF) Part 2: Characteristics and management of AF ECAS 2014 CHAIRED POSTER SESSION C: PARTS 1 AND 2 Monday, March 24, 2014, 8:30 AM–12:00 PM Part 1: Arrhythmia mechanisms. Monitoring and patient preference Part 2: Life-threatening ventricular arrhythmias. Teaching methods and tools ECAS 2014 CHAIRED POSTER SESSION D: PARTS 1 AND 2 Monday, March 24, 2014, 2:00 PM–05:30 PM Part 1: Implantable cardioverter defibrillators. New mapping techniques Lead extraction and complications Part 2: AF and atrial flutter ablation. Lead-related complications
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Invitation
Dear Colleagues, This is an invitation to join us at the Tenth Annual Scientific Congress of the European Cardiac Arrhythmia Society “ECAS” to be held in Munich, Germany March 23 to 25, 2014 at the prestigious Bayerischer Hof Hotel. All those who attended previous editions of ECAS Congress know that it is a highly scientific and educational event in a cheerful atmosphere which facilitates the interaction between the renowned Faculty and other colleagues in the field. This edition promises to be particularly successful and we will be delighted to welcome you in Munich next March.
Riccardo Cappato, MD President of ECAS
Stefan Kääb, MD Congress Chairman
Ellen Hoffmann, MD Scientific Program Chair
Executive Committee of the European Cardiac Arrhythmia Society
President Past President Vice-President Vice-President Vice-President Treasurer Secretary General Committees Educational activities Relationship with other Societies Membership program Annual Session program committee
Riccardo Cappato (Milan, IT) Wyn Davies (London, GB) (Education & Research) Richard Hauer (Utrecht, NL) (National Societies) Massimo Santini (Rome, IT) (International Societies & EU) Samuel Lévy (Marseille, FR) Eli Ovsyshcher (Beersheba, IL) Leo Van Wersch (Paris, FR)
Nicholas Peters (London, GB) Stefan Kääb (Munich, DE) Neil Sulke, MD (Eastbourne, GB) Gerhard Steinbeck (Munich, DE)
Organizing Committee ECAS 2014 Gerhard Steinbeck, Riccardo Cappato, Heidi Estner, Ellen Hoffmann, Stefan Kääb, Michael Näbauer, Samuel Lévy (Chair), Reza Wakili
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Gerhard Steinbeck MD
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Samuel Lévy, MD
Michael Näbauer, MD
Program Committee
Andrey Ardashev, Alawi Alsheikh Ali, Leonardo Calo, David Cannom, Riccardo Cappato, Wyn Davies, Roberto de Ponti, Heidi Estner, Mark Estes III, Jeronimo Farre, John Fisher, Robert Hatala, Richard Hauer, Fernand Hessel, Ellen Hoffmann (Program Chair), Charles Jazra, Xavier Jouven, Stefan Kääb, Gilles Lascault, Jean-François Leclercq, Jean-Yves Le Heuzey, Samuel Lévy, Thorsten Lewalter, Shaowen Liu, Peter Loh, Pierpaolo Lupo, Michael Näbauer, Yugi Nakazato, Andrea Natale, Promund Obel, Eli Ovsyshcher, Douglas L Packer, Luigi Padeletti, Nicholas S. Peters, Dubravko Petrac, Antonio Raviele, Amiran Revishvilli, Edward Rowland, Frederic Sacher, Sanjeev Saksena, Richard Schilling, Gerhard Steinbeck, Massimo Santini, Neil Sulke, Uwe Dorwarth, Reza Wakili, Bruce Wilkoff.
Scientific Advisory Board
Masood Akhtar (Milwaukee, USA) Etienne Aliot (Nancy, FR) Maurits A. Allessie (Maastricht, NL) Eckhard Alt (Munich, DE) Charles Antzelevitch (Utica, USA) Andrey Ardashev (Moscow, RU) Serge S. Barold (Boca Raton, USA) David Benditt (Minneapolis, USA) Poul Erik Bloch-Thomsen (Hellerup, DK) Jozsef Borbola (Budapest, HU) Johannes Brachmann (Coburg, DE) A John Camm (London, GB) Alessandro Capucci (Ancona, IT) Riccardo Cappato (Milan, IT) David S. Cannom (Los Angeles, USA) Sumeet Chugh (Los Angeles, USA) Antonio Curnis (Brescia, IT) Philippe Coumel* D. Wyn Davies (London, GB) Hu Dayi (Beijing, CN) Luc De Roy (Yvoir, BE) Sergio Dubner (Buenos Aires, AR) Nils G. Edvardsson (Goteborg, SE)
Michaël Eldar (Tel Aviv, IL) Nabil El-Sherif (New York, USA) Jeronimo Farre (Madrid, ES) John Fisher (New York, USA) Guy Fontaine (Paris, FR) Robert Frank (Paris, FR) Seymour Furman (New York, USA)* Bulent Gorenek (Eskisehir, TR) Stephen C. Hammill (Rochester, MN, USA) Richard Hauer(Utrecht, NL) Habib Haouala (Tunis, TN) Yoshito Iesaka (Tokyo, JP) Michiel Janse (Amsterdam, NL) Charles Jazra (Beirut, LB) Xavier Jouven (Paris, FR) Werner Jung (Villingen, DE) Stefan Kääb (Munich, DE) Prapa Kanagaratnam (London, GB) Joergen Kanters (Copenhagen, DK) Bondo Kobulia (Tbilisi, GE) Karl-Heinz Kuck (Hamburg, DE) Jean-François Leclercq (Paris, FR)
Jean-Yves Le Heuzey (Paris, FR) Samuel Lévy (Marseille, FR) Berndt Luderitz (Bonn, DE) Damian Gascon Lopez (Sevilla, ES) Marek Malik (London, GB) Douglas L. Packer (Rochester, USA) Luigi Padeletti (Florence, IT) Nicholas S Peters (London, GB) Dubravko Petrac (Zagreb, HR) Eric N. Prystowsky (Indianapolis, USA) Antonio Raviele(Venice, IT) Amiran Revishvili (Moscow, RU) Dwight Reynolds (Oklahoma, USA) Edward Rowland (London, GB) Sanjeev Saksena (New Brunswick, USA) Harry G. Mond (Melbourne, AU) Alessandro A Montenero (Rome, IT) Conception Moro Serrano (Madrid, ES) Arthur J. Moss (Rochester, NY, USA) Michael Nabauer (Munich, DE) Gerald V. Nacarelli (Hershey, USA) Yuji Nakazato (Tokyo, JP) Massimo Santini (Rome, IT)
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Maurizio Santomauro (Naples, IT) Dipen Shah (Geneva, CH) Richard Schilling (London, GB) Georg Schmidt (Munich, DE) Jabir Sra (Milwaukee, USA) Gerhard Steinbeck (Munich, DE) Neil Sulke (Eastbourne, GB) Paul Touboul (Lyon, FR)
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Albert Waldo (Cleveland, USA) Andrea Natale (Cleveland, USA) Promund I. W. Obel (Johannesburg, ZA) Brian Olshansky (Iowa City, USA) Bertil S. Olsson (Lund, SE) Oscar Oseroff (Buenos Aires, AR) Ali Oto (Ankara, TR) Eli Ovsyshcher (Beersheba, IL)
Hein JJ Wellens (Maastricht, NL) Bruce Wilkoff (Cleveland, USA) David Wilber (Chicago, USA) George D. Wyse (Calgary, CA)
*
In memoriam
Abstract Selection The Organizing committee would like to thank the abstract reviewers for their valuable help in abstract selection of ECAS 2014 program: Etienne Aliot; Serge Barold; Luigi Di Biase; Poul Erik Bloch-Thomsen; Martin Borggrefe; Johannes Brachmann; Gunter Breithardt; Leonardo Calo; John Camm; Riccardo Cappato; Alessandro Capucci; Sumeet Chugh; Julian Chun; Harry Crijns; Eugene Crystal; Wyn Davies; Pascal Defaye; Mario Delmar; Dobromir Dobrev; Mark Estes III; Heidi Estner; Jeronimo Farre; Ali Fathi; John Fisher; Gerard Guiraudon; Sam Hanon; Richard Hauer; Hein Heidbuchel; Bengt Herweg; Ellen Hoffmann; Shigeru Ikeguchi; Carsten Israel; Michiel Janse; Werner Jung; Prapa Kanagaratnam; Jörgen Kanters; Helmut Klein; Peter Loh; Nicolas Lellouche; Berndt Lüderitz; Pierpaolo Lupo; Marek Malik; Annibale S. Montenero; Robert Myerburg; Michael Näbauer; Gerald Naccarelli; Yugi Nakazato; Pro Obel; Brian Olshansky; Ali Oto; Eli Ovsyshcher; Luigi Padeletti; Douglas Packer; Nicholas Peters; Dubravko Petrac; Roberto de Ponti; Jeanne Poole; Antonio Raviele; Edward Rowland; Sanjeev Saksena; Massimo Santini; Nabil El Sherif; Peter Schwartz; Robert Schweikert; Dipen Shah; Claudio Schuger; Jasbir Sra; Gerhard Steinbeck; Neil Sulke; Tamas Szili-Török; Jacob TfeltHansen; Reza Wakili; Albert Waldo; Roger Winkle Congress Venue Hotel Bayerischer Hof Promenadeplatz 2–6 D-80333 Munich Tel: +49 89 2120 900 Fax: +49 89 2120 906 www.bayerischerhof.de Congress Chairman Stefan Kääb, Prof. Dr Ludwig-Maximilians University (LMU) Klinikum Grosshadern Medizinische Klinik und Poliklinik I Marchioninistr. 15 81377 München [email protected] Abstract Awards Presentation of the ECAS Outstanding Awards and Support Awards and for Best Oral Abstract Awards will take place during the Opening Ceremony on March 23 at Room Konigssaal at Hotel Bayerischer Hof from 5:30 to 7 PM Presentation of the Best Posters and Awards to the Awardees of the Best Abstracts will take place on Tuesday March 25th from 12:00 to 12:30 pm Room Furstensalon (Hotel Bayerischer Hof).
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
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10th Philippe Coumel Lecture 2014 Will be presented on Sunday March 23 from 5:30 to 6:00 PM as part of the Opening Ceremony A tribute to Philippe Coumel
By Prof. Jeronimo Farré (Madrid, ES)
“A Brief History of the Exploration of the AV Junction” Badges Badges and Final programs will be available at the Hotel Bayerischer Hof, Munich, for pre-registered participants and Faculty at the ECAS welcome desk starting Saturday March 22nd, 2014 from 2:00 to 6:00 PM ECAS Congress Secretariat Josette Razafimbelo Tel: + 33 (0)4 89 14 45 33 Cell: +336 26 07 55 74 E-mail: [email protected] Registration Registration and payment of Congress fees as well as payment of Membership dues can be done through the website. Registration on site will start on Sunday March 23rd at 8:00 AM at Hotel Bayerischer Hof. Currency Payment in cash for registration on site must be made in euros only. Payment using American Express or Visa credit cards will be accepted on the Congress site. Personal checks cannot be accepted. Congress Website All information, Scientific Program and Registration to the congress, Abstract submission and Membership subscription with secured payment can be done through our website http://www.ecas-heartrhythm.org Pre-Arranged Sessions The Program includes 32 Pre-arranged sessions and workshops or debates. It can be downloaded from our website as well as the Program of Abstracts selected for oral or poster presentations
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Publications
JICE (Journal of Interventional Cardiac Electrophysiology) is the official Journal of the European Cardiac Arrhythmia Society.
Sanjeev Saksena MD JICE Editor-in-Chief
Leonardo Calo MD ECAS JICE Co-Editor
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
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Abstract Presentations The abstracts accepted for oral or poster presentation will be published in a supplement issue of the Journal of Interventional Cardiac Electrophysiology (JICE), the official journal of ECAS provided the authors attend the congress and present their work. The oral presentation of abstracts is 10 min plus 5 min for discussion. All posters accepted for presentation will be chaired. Please check the day and time at which your poster will be presented to the chairpersons and the time at which the presenter should be near their poster board.
PROGRAM AT A GLANCE SUNDAY MARCH 23, 2014 8:00 am 5:00 pm 8:30 am 10:00 am
Registration Concurrent Workshops Room Furstensalon WS-01 Ablation of AF
Room Gelbersalon WS-02 Sports and arrhythmias
Workshop WS-03 Room Montgelassaal New oral
D. Packer
M. Estes
Anticoagulants (NOACs)
Room Palaishalle Chaired poster Session A
10:00 am–10:30 am : Coffee break and visit to the posters 10:30 am Concurrent Abstract Sessions 12:00 pm Room Room Room Room Konigssaal Furstensalon Gelbersalon Montgelassa al Oral Abstract session 01 Oral Abstract session 02 Oral Abstract session 03 Oral Abstract Session 04 SCD
Anticoagulants
12:15 pm–1:45 pm Seated Luncheon Panel 1 Restaurant PALAISSTUBE TBA
2:00 pm 3:30 pm
Room Konigssaal Session DT-01
Room Furstensalon Session MA-01
Epidemiology and mechanisms of SCD
Mechanisms of ventricular arrhythmias
AF management
Room Palaishalle Chaired poster Session A (Cont.)
Mechanisms
12:15 pm–1:45 pm Seated Luncheon Panel 2 Restaurant REFEKTORIUM Anticoagulation for stroke prevention in Atrial Fibrillation Supported by an educational grant from Boehringer-Ingelheim Room Room Room Gelbersalon Montgelassaal Palaishalle DT-02 SP-01 Chaired poster Session B Prevention of Device EPIC Alliance Complications -ECAS session
Coffee break 4:00 pm 5:30 pm
Room Konigssaal Debate
Room Furstensalon session MA-02
Room Gelbersalon Symposium
Room Montgelassaal SP-02
Room Palaishalle Chaired poster
Ablate and Pace Round Table Rotors in AF
VT: Role of fibrosis For ablation
DT-03 Living with an ICD
Asymptomatic inherited Arrhythmia syndromes
Session B (continued)
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
5:30 pm Room Koningssaal 6:00 pm The Philippe Coumel Lecture By Prof. Jeronimo Farre (Madrid, ES) A Brief History of the Exploration of the AV Junction 6:00 pm–7:00 pm Opening Ceremony Followed by a cocktail reception for all participants
MONDAY March 24, 2014 8:30 am 10:00 am
Room Konigssaal DT-04 The future of ICDs
Room Furstensalon SP-03 Clinical and technical challenges in mapping and ablation
Room Gelbersalon SP-04 Future of antiarrhythmic agents
Room Montgelassaal WS- 04 ECG pacemaker and CRT dysfunction E. Ovshyscher, C. Israel, B. Herweg E. Crystal
Room Palaishalle Chaired poster Session C
10:00 am–10:30 am: Coffee break and visit to Posters Time 10:30 am 12:00 pm
Simultaneous Oral Abstract sessions Room Room Room Room Room Konigssaal Furstensalon Gelbersalon Montgelassaal Palaishalle Oral abstract session 5 Oral abstract Oral abstract session 7 Oral abstract Chaired poster session 6 session 8 Session C 12:15 pm–1:45 pm 12:15 pm–1:45 pm Restaurant PALAISSTUBE Restaurant REFEKTORIUM Luncheon Panel 3 Luncheon Panel 4 Available Supported by an educational grant from Bayer Pharma AG Anticoagulation for Atrial Fibrillation
2:00 pm 3:30 pm
Room Konigssaal Session DT-05 CRT : Update on guidelines
Room Furstensalon SP-05 Catheter ablation of AF Various aspects of the procedure
Room Gelbersalon DT-06 Advances in device therapy
Room Montgelassaal SP-06 Translational Research in Electrophysiology
Room Palaishalle Chaired poster Session D
Coffee break 3:30 pm–4:00 pm and visit to Poster area Time 4:00 pm 5:30 pm
5:30 pm 7:00 pm
Simultaneous sessions Room Konigssaal SP-07 Ablation of frequent premature ventricular contractions (PVCs)
Room Konigssaal SP-11
Room Furstensalon Symposium
Room Gelbersalon SP-09
Room Montgelassaal SP-10
Room Palaishalle Chaired poster
SP-08
Russian Society of arrhythmology (RSA)
Innovations in AF ablation
Session D (continued)
7 th Japan HRS-ECAS Special session Y. Nakazato Room Furstensalon
A. Revishvili D. Shah Room Gelbersalon SP-12 ECAS-WSA
Room Montgelassaal
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119 Time
Simultaneous sessions Left atrial Ablation: Where do we stand after more than 10 years?
MA-03 Mechanisms of AF perpetuation
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Health technology assessment in CIEDs Electronic Devices M. Santini
SP-13 Patients at high risk of sudden cardiac death
TUESDAY MARCH 25, 2014 8:30 am 10:00 am
Room Watteau Oral abstract session 9 CRT
Room Furstensalon Oral abstract session 10 VT/VF
Room Gelbersalon Oral abstract session 11 AF progression and mechanisms
Room Montgelassaal Oral abstract session 12 Antiarrhythmics
Coffee break 10:30 am Room Watteau 12:00 pm SP-14 Silent AF
Room Furstensalon Room Gelbersalon Room Montgelassaal DT-07 WS-06 SP-15 Lead extraction: How did Techniques and tools for When a simple arrhythmia ablation I manage my worse case ? AF ablation turn into a complex case: N. Sulke-R. De Ponti How did I manage it
12:00 pm Room Furstensalon 12:30 pm Presentation of the Best Posters and Awards to the Awardees of the Best Abstracts
Abstract Oral Session 1: Risk factors, epidemiology and prevention of sudden cardiac death Sunday, March 23, 2014, 10:30 am–12:00 pm; ROOM KONIGSSAAL 1–1 Abstract 07–18 INCIDENCE, CHARACTERISTICS AND OUTCOME OF SUDDEN CARDIAC ARREST DURING SPORTS IN WOMEN Eloi Marijon1, Wulfran Bougouin1, Lionel Lamhaut1, Florence Dumas1, Jean-Yves Le Heuzey2, Jean-Philippe Empana1, Xavier Jouven1 1 Paris Cardiovascular Research Center, Paris, France, 2 Cardiology Department, European Georges Pompidou Hospital, Paris, France Background: No specific data are available on the characteristics and outcome of sudden cardiac death (SCD) during sport activities among women in the general population. Methods and results: From a prospective 5year national survey, involving 820 subjects aged 10– 75 years who presented with SCD (resuscitated or not) during competitive or recreational sport activities, 43
(5.2 %) such events occurred in women, principally during jogging, cycling and swimming. The level of activity at the time of SCD was moderate to vigorous in 35 cases (81.4 %). The overall incidence of sportrelated SCD, among 15–75-year-old women, was estimated as 0.59 (95%CI 0.39 to 0.79) to 2.17 (95%CI 1.38 to 2.96) per year per million female sports participants for the 80th and 20th percentiles of reporting districts, respectively. Compared to men, the incidence of SCD in women was dramatically lower, particularly in the 45–54 years range (relative risk 0.033, 95%CI 0.015 to 0.075). Despite very similar circumstances of occurrence, survival at hospital admission (46.6 %, 95%CI 31.0 to 60.0) was significantly higher than for men (30.0 %, 95 % 26.8–33.2, P=0.02), although this did not reach statistical significance for hospital discharge. Favorable neurological outcomes were similar (80 %). Cause of death appeared less likely to be associated with structural heart disease in women, compared to men (58.3 % vs. 95.8 %, P = 0.0003). Conclusions: Sports-related SCD in women participants appears dramatically less common (up to 30fold less frequent), compared to men. Our results also suggest a higher likelihood of successful resuscitation as well as la lower frequency of structural heart disease in women, compared to men.
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1–2 Abstract 07–11 SPORTS-RELATED SUDDEN CARDIAC DEATH IN A COMPETITIVE AND NON-COMPETITIVE ATHLETE POPULATION AGED 12–49 YEARS: DATA FROM A NATIONWIDE STUDY IN DENMARK Bjarke Risgaard1, Bo Gregers Winkel1, Reza Jabbari1, Charlotte Glinge1, Ole Ingemann-Hansen2, Jørgen Lange Thomsen3, Gyda Lolk Ottesen4, Stig Haunsø1, Anders Gaarsdal Holst1, Jacob Tfelt-Hansen1 1 Rigshospitalet, Copenhagen, Denmark, 2 Aarhus University, Aarhus, Denmark, 3University of Southern Denmark, Odense, Denmark, 4Copenhagen University, Copenhagen, Denmark Background: Sports-related sudden cardiac deaths (SrSCD’s) in athletes are tragic events. Data on SrSCD’s in competitive athletes >35 years are limited. We aimed to characterize all SrSCD’s aged 12– 49 years and to address the difference in incidence rates between competitive and non-competitive athletes. Methods: All deaths in Denmark in persons aged 12–49 years in 2007–2009 were included. Death certificates were reviewed. History of previous admissions to hospital was assessed, discharge summaries, and autopsy reports were read. Sudden cardiac deaths (SCD’s) and SrSCD cases were identified. Results: In the 3-year period, there were 881 SCD’s of which we identified 44 SrSCD’s. In non-competitive athletes, the incidence rate of SrSCD was 0.43 (95 % CI: 0.16 to 0.94) and 2.95 (95 % CI: 1.95 to 4.30) per 100,000 athlete person-years in those aged 12– 35 years and 36–49 years, respectively. In competitive athletes the incidence rate of SrSCD was 0.47 (95 % CI: 0.10 to 1.14) and 6.64 (95 % CI: 2.86 to 13.1) per 100,000 athlete person-years in those aged 12– 35 years and 36–49 years, respectively. The incidence rate of SCD in the general population was much higher. Most common cause of death was coronary artery disease (n = 15, 43 %) and several athletes (n = 30, 68 %) had possible cardiac symptoms prior to death of which angina was the most predominant (n = 17, 39 %) (Table 1). Conclusion: The incidence rate of SrSCD in non-competitive and competitive athletes is similar in the young. Importantly, SCD in the general population is much more prevalent than SrSCD. The present study suggests that preparticipation screening will be ethically problematic, if only provided to those (young people) involved in competitive sports. Raised awareness on cardiac symptoms prior to death is warranted.
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Age group (years)
12–49
12–35
36–49
SrSCD cases (n)
44
9
35
Of whom were competitive athletes (n) Age group population, in thousands Active competitive athletes
11
3
8
2,735
1,618
1,116
8.9 %
13.2 %
3.6 %
Active non-competitive athletes Incidence rates per 100,000 person-years (denominator) SCD (general population)
28.1 %
28.7 %
27.3 %
(95 % CI)
(95 % CI)
(95 % CI)
10.7 (10.0–11.5) 3.15 (2.67–3.69) 21.7 (20.1–23.4)
SrSCD†(general population) 0.54 (0.39–0.72) 0.19 (0.08–0.35) 1.05 (0.73–1.45) Non-competitive athletes (non-competitive athletes) Competitive athletes (competitive athletes) Most common cause of death at autopsy, n (%) Coronary artery disease
1.43 (0.99–2.01) 0.43 (0.16–0.94) 2.95 (1.95–4.30)
15 (43)
2 (22)
13 (50)
Arrhythmogenic right ventricular cardiomyopathy Hypertrophic heart
5 (14)
3 (22)
2 (8)
4 (11)
–
4 (15)
Sudden unexplained death
4 (11)
2 (22)
2 (8)
Myocarditis
2 (6)
–
2 (8)
Other
5 (14)
2 (22)
3 (12)
Any possible cardiac symptom, n (%) Angina
30 (68)
5 (56)
25 (71)
17 (39)
1 (11)
16 (46)
Syncope
10 (23)
5 (56)
5 (14)
1.51 (0.75–2.71) 0.47 (0.10–1.14) 6.64 (2.86–13.1) 12–49 (n=35)
12–35 (n=9)
36–49 (n=26)
Dyspnoea
10 (23)
1 (11)
9 (26)
Other
16 (36)
3 (33)
13 (37)
Antecedent (
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Special Abstract issue for the 10th Congress of the European Cardiac Arrhythmia Society (ECAS) March 23–25, 2014 Munich, Germany Guest Editor: Prof. Samuel Lévy, MD Aix-Marseille Université, Marseille, France INVITATION PROGRAM AT A GLANCE 10th Annual Congress of the European Cardiac Arrhythmia Society ECAS 2014 ORAL ABSTRACT SESSIONS 1–4 Sunday, March 23, 2014, 10:30 AM–12:00 PM Oral Abstract Session 1: Risk factors, epidemiology and prevention of sudden cardiac death Oral Abstract Session 2: Oral anticoagulants for stroke prevention in atrial fibrillation (AF) Oral Abstract Session 3: Pharmacological and non-pharmacological management of AF Oral Abstract Session 4: Mechanisms of cardiac arrhythmias ECAS 2014 ORAL ABSTRACT SESSIONS 5–8 Monday, March 24, 2014, 10:30 AM–12:00 PM Oral Abstract Session 5: AF Ablation techniques and prevention of complications Oral Abstract Session 6: Efficacy and potential complications of ICD Therapy Oral Abstract Session 7: Genetic aspects of cardiac arrhythmias Oral Abstract Session 8: Issues in permanent cardiac pacing ECAS 2014 ORAL ABSTRACT SESSIONS 9–12 Tuesday, March 25, 2014, 8:30 AM–10:00 AM Oral Abstract Session 9: Improvement in CRT results Oral Abstract Session 10: Diagnosis and management of VT/VF Oral Abstract Session 11: AF mechanisms and progression Oral Abstract Session 12: Antiarrhythmic drugs therapy ECAS 2014 CHAIRED POSTER SESSION A: PARTS 1 AND 2 Sunday, March 23, 2014, 8:30 AM–12:00 PM Part 1: Supraventricular arrhythmia management and prevention Antiarrhythmic drug therapy Part 2: Issues in cardiac pacing Cardiac Resynchronization Therapy
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Syncope ECAS 2014 CHAIRED POSTER SESSION B: PARTS 1 AND 2 Sunday, March 23, 2014, 2:00 PM–5:30 PM Part 1: Ablation of atrial fibrillation (AF) Part 2: Characteristics and management of AF ECAS 2014 CHAIRED POSTER SESSION C: PARTS 1 AND 2 Monday, March 24, 2014, 8:30 AM–12:00 PM Part 1: Arrhythmia mechanisms. Monitoring and patient preference Part 2: Life-threatening ventricular arrhythmias. Teaching methods and tools ECAS 2014 CHAIRED POSTER SESSION D: PARTS 1 AND 2 Monday, March 24, 2014, 2:00 PM–05:30 PM Part 1: Implantable cardioverter defibrillators. New mapping techniques Lead extraction and complications Part 2: AF and atrial flutter ablation. Lead-related complications
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Invitation
Dear Colleagues, This is an invitation to join us at the Tenth Annual Scientific Congress of the European Cardiac Arrhythmia Society “ECAS” to be held in Munich, Germany March 23 to 25, 2014 at the prestigious Bayerischer Hof Hotel. All those who attended previous editions of ECAS Congress know that it is a highly scientific and educational event in a cheerful atmosphere which facilitates the interaction between the renowned Faculty and other colleagues in the field. This edition promises to be particularly successful and we will be delighted to welcome you in Munich next March.
Riccardo Cappato, MD President of ECAS
Stefan Kääb, MD Congress Chairman
Ellen Hoffmann, MD Scientific Program Chair
Executive Committee of the European Cardiac Arrhythmia Society
President Past President Vice-President Vice-President Vice-President Treasurer Secretary General Committees Educational activities Relationship with other Societies Membership program Annual Session program committee
Riccardo Cappato (Milan, IT) Wyn Davies (London, GB) (Education & Research) Richard Hauer (Utrecht, NL) (National Societies) Massimo Santini (Rome, IT) (International Societies & EU) Samuel Lévy (Marseille, FR) Eli Ovsyshcher (Beersheba, IL) Leo Van Wersch (Paris, FR)
Nicholas Peters (London, GB) Stefan Kääb (Munich, DE) Neil Sulke, MD (Eastbourne, GB) Gerhard Steinbeck (Munich, DE)
Organizing Committee ECAS 2014 Gerhard Steinbeck, Riccardo Cappato, Heidi Estner, Ellen Hoffmann, Stefan Kääb, Michael Näbauer, Samuel Lévy (Chair), Reza Wakili
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Gerhard Steinbeck MD
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Samuel Lévy, MD
Michael Näbauer, MD
Program Committee
Andrey Ardashev, Alawi Alsheikh Ali, Leonardo Calo, David Cannom, Riccardo Cappato, Wyn Davies, Roberto de Ponti, Heidi Estner, Mark Estes III, Jeronimo Farre, John Fisher, Robert Hatala, Richard Hauer, Fernand Hessel, Ellen Hoffmann (Program Chair), Charles Jazra, Xavier Jouven, Stefan Kääb, Gilles Lascault, Jean-François Leclercq, Jean-Yves Le Heuzey, Samuel Lévy, Thorsten Lewalter, Shaowen Liu, Peter Loh, Pierpaolo Lupo, Michael Näbauer, Yugi Nakazato, Andrea Natale, Promund Obel, Eli Ovsyshcher, Douglas L Packer, Luigi Padeletti, Nicholas S. Peters, Dubravko Petrac, Antonio Raviele, Amiran Revishvilli, Edward Rowland, Frederic Sacher, Sanjeev Saksena, Richard Schilling, Gerhard Steinbeck, Massimo Santini, Neil Sulke, Uwe Dorwarth, Reza Wakili, Bruce Wilkoff.
Scientific Advisory Board
Masood Akhtar (Milwaukee, USA) Etienne Aliot (Nancy, FR) Maurits A. Allessie (Maastricht, NL) Eckhard Alt (Munich, DE) Charles Antzelevitch (Utica, USA) Andrey Ardashev (Moscow, RU) Serge S. Barold (Boca Raton, USA) David Benditt (Minneapolis, USA) Poul Erik Bloch-Thomsen (Hellerup, DK) Jozsef Borbola (Budapest, HU) Johannes Brachmann (Coburg, DE) A John Camm (London, GB) Alessandro Capucci (Ancona, IT) Riccardo Cappato (Milan, IT) David S. Cannom (Los Angeles, USA) Sumeet Chugh (Los Angeles, USA) Antonio Curnis (Brescia, IT) Philippe Coumel* D. Wyn Davies (London, GB) Hu Dayi (Beijing, CN) Luc De Roy (Yvoir, BE) Sergio Dubner (Buenos Aires, AR) Nils G. Edvardsson (Goteborg, SE)
Michaël Eldar (Tel Aviv, IL) Nabil El-Sherif (New York, USA) Jeronimo Farre (Madrid, ES) John Fisher (New York, USA) Guy Fontaine (Paris, FR) Robert Frank (Paris, FR) Seymour Furman (New York, USA)* Bulent Gorenek (Eskisehir, TR) Stephen C. Hammill (Rochester, MN, USA) Richard Hauer(Utrecht, NL) Habib Haouala (Tunis, TN) Yoshito Iesaka (Tokyo, JP) Michiel Janse (Amsterdam, NL) Charles Jazra (Beirut, LB) Xavier Jouven (Paris, FR) Werner Jung (Villingen, DE) Stefan Kääb (Munich, DE) Prapa Kanagaratnam (London, GB) Joergen Kanters (Copenhagen, DK) Bondo Kobulia (Tbilisi, GE) Karl-Heinz Kuck (Hamburg, DE) Jean-François Leclercq (Paris, FR)
Jean-Yves Le Heuzey (Paris, FR) Samuel Lévy (Marseille, FR) Berndt Luderitz (Bonn, DE) Damian Gascon Lopez (Sevilla, ES) Marek Malik (London, GB) Douglas L. Packer (Rochester, USA) Luigi Padeletti (Florence, IT) Nicholas S Peters (London, GB) Dubravko Petrac (Zagreb, HR) Eric N. Prystowsky (Indianapolis, USA) Antonio Raviele(Venice, IT) Amiran Revishvili (Moscow, RU) Dwight Reynolds (Oklahoma, USA) Edward Rowland (London, GB) Sanjeev Saksena (New Brunswick, USA) Harry G. Mond (Melbourne, AU) Alessandro A Montenero (Rome, IT) Conception Moro Serrano (Madrid, ES) Arthur J. Moss (Rochester, NY, USA) Michael Nabauer (Munich, DE) Gerald V. Nacarelli (Hershey, USA) Yuji Nakazato (Tokyo, JP) Massimo Santini (Rome, IT)
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Maurizio Santomauro (Naples, IT) Dipen Shah (Geneva, CH) Richard Schilling (London, GB) Georg Schmidt (Munich, DE) Jabir Sra (Milwaukee, USA) Gerhard Steinbeck (Munich, DE) Neil Sulke (Eastbourne, GB) Paul Touboul (Lyon, FR)
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Albert Waldo (Cleveland, USA) Andrea Natale (Cleveland, USA) Promund I. W. Obel (Johannesburg, ZA) Brian Olshansky (Iowa City, USA) Bertil S. Olsson (Lund, SE) Oscar Oseroff (Buenos Aires, AR) Ali Oto (Ankara, TR) Eli Ovsyshcher (Beersheba, IL)
Hein JJ Wellens (Maastricht, NL) Bruce Wilkoff (Cleveland, USA) David Wilber (Chicago, USA) George D. Wyse (Calgary, CA)
*
In memoriam
Abstract Selection The Organizing committee would like to thank the abstract reviewers for their valuable help in abstract selection of ECAS 2014 program: Etienne Aliot; Serge Barold; Luigi Di Biase; Poul Erik Bloch-Thomsen; Martin Borggrefe; Johannes Brachmann; Gunter Breithardt; Leonardo Calo; John Camm; Riccardo Cappato; Alessandro Capucci; Sumeet Chugh; Julian Chun; Harry Crijns; Eugene Crystal; Wyn Davies; Pascal Defaye; Mario Delmar; Dobromir Dobrev; Mark Estes III; Heidi Estner; Jeronimo Farre; Ali Fathi; John Fisher; Gerard Guiraudon; Sam Hanon; Richard Hauer; Hein Heidbuchel; Bengt Herweg; Ellen Hoffmann; Shigeru Ikeguchi; Carsten Israel; Michiel Janse; Werner Jung; Prapa Kanagaratnam; Jörgen Kanters; Helmut Klein; Peter Loh; Nicolas Lellouche; Berndt Lüderitz; Pierpaolo Lupo; Marek Malik; Annibale S. Montenero; Robert Myerburg; Michael Näbauer; Gerald Naccarelli; Yugi Nakazato; Pro Obel; Brian Olshansky; Ali Oto; Eli Ovsyshcher; Luigi Padeletti; Douglas Packer; Nicholas Peters; Dubravko Petrac; Roberto de Ponti; Jeanne Poole; Antonio Raviele; Edward Rowland; Sanjeev Saksena; Massimo Santini; Nabil El Sherif; Peter Schwartz; Robert Schweikert; Dipen Shah; Claudio Schuger; Jasbir Sra; Gerhard Steinbeck; Neil Sulke; Tamas Szili-Török; Jacob TfeltHansen; Reza Wakili; Albert Waldo; Roger Winkle Congress Venue Hotel Bayerischer Hof Promenadeplatz 2–6 D-80333 Munich Tel: +49 89 2120 900 Fax: +49 89 2120 906 www.bayerischerhof.de Congress Chairman Stefan Kääb, Prof. Dr Ludwig-Maximilians University (LMU) Klinikum Grosshadern Medizinische Klinik und Poliklinik I Marchioninistr. 15 81377 München [email protected] Abstract Awards Presentation of the ECAS Outstanding Awards and Support Awards and for Best Oral Abstract Awards will take place during the Opening Ceremony on March 23 at Room Konigssaal at Hotel Bayerischer Hof from 5:30 to 7 PM Presentation of the Best Posters and Awards to the Awardees of the Best Abstracts will take place on Tuesday March 25th from 12:00 to 12:30 pm Room Furstensalon (Hotel Bayerischer Hof).
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
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10th Philippe Coumel Lecture 2014 Will be presented on Sunday March 23 from 5:30 to 6:00 PM as part of the Opening Ceremony A tribute to Philippe Coumel
By Prof. Jeronimo Farré (Madrid, ES)
“A Brief History of the Exploration of the AV Junction” Badges Badges and Final programs will be available at the Hotel Bayerischer Hof, Munich, for pre-registered participants and Faculty at the ECAS welcome desk starting Saturday March 22nd, 2014 from 2:00 to 6:00 PM ECAS Congress Secretariat Josette Razafimbelo Tel: + 33 (0)4 89 14 45 33 Cell: +336 26 07 55 74 E-mail: [email protected] Registration Registration and payment of Congress fees as well as payment of Membership dues can be done through the website. Registration on site will start on Sunday March 23rd at 8:00 AM at Hotel Bayerischer Hof. Currency Payment in cash for registration on site must be made in euros only. Payment using American Express or Visa credit cards will be accepted on the Congress site. Personal checks cannot be accepted. Congress Website All information, Scientific Program and Registration to the congress, Abstract submission and Membership subscription with secured payment can be done through our website http://www.ecas-heartrhythm.org Pre-Arranged Sessions The Program includes 32 Pre-arranged sessions and workshops or debates. It can be downloaded from our website as well as the Program of Abstracts selected for oral or poster presentations
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Publications
JICE (Journal of Interventional Cardiac Electrophysiology) is the official Journal of the European Cardiac Arrhythmia Society.
Sanjeev Saksena MD JICE Editor-in-Chief
Leonardo Calo MD ECAS JICE Co-Editor
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
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Abstract Presentations The abstracts accepted for oral or poster presentation will be published in a supplement issue of the Journal of Interventional Cardiac Electrophysiology (JICE), the official journal of ECAS provided the authors attend the congress and present their work. The oral presentation of abstracts is 10 min plus 5 min for discussion. All posters accepted for presentation will be chaired. Please check the day and time at which your poster will be presented to the chairpersons and the time at which the presenter should be near their poster board.
PROGRAM AT A GLANCE SUNDAY MARCH 23, 2014 8:00 am 5:00 pm 8:30 am 10:00 am
Registration Concurrent Workshops Room Furstensalon WS-01 Ablation of AF
Room Gelbersalon WS-02 Sports and arrhythmias
Workshop WS-03 Room Montgelassaal New oral
D. Packer
M. Estes
Anticoagulants (NOACs)
Room Palaishalle Chaired poster Session A
10:00 am–10:30 am : Coffee break and visit to the posters 10:30 am Concurrent Abstract Sessions 12:00 pm Room Room Room Room Konigssaal Furstensalon Gelbersalon Montgelassa al Oral Abstract session 01 Oral Abstract session 02 Oral Abstract session 03 Oral Abstract Session 04 SCD
Anticoagulants
12:15 pm–1:45 pm Seated Luncheon Panel 1 Restaurant PALAISSTUBE TBA
2:00 pm 3:30 pm
Room Konigssaal Session DT-01
Room Furstensalon Session MA-01
Epidemiology and mechanisms of SCD
Mechanisms of ventricular arrhythmias
AF management
Room Palaishalle Chaired poster Session A (Cont.)
Mechanisms
12:15 pm–1:45 pm Seated Luncheon Panel 2 Restaurant REFEKTORIUM Anticoagulation for stroke prevention in Atrial Fibrillation Supported by an educational grant from Boehringer-Ingelheim Room Room Room Gelbersalon Montgelassaal Palaishalle DT-02 SP-01 Chaired poster Session B Prevention of Device EPIC Alliance Complications -ECAS session
Coffee break 4:00 pm 5:30 pm
Room Konigssaal Debate
Room Furstensalon session MA-02
Room Gelbersalon Symposium
Room Montgelassaal SP-02
Room Palaishalle Chaired poster
Ablate and Pace Round Table Rotors in AF
VT: Role of fibrosis For ablation
DT-03 Living with an ICD
Asymptomatic inherited Arrhythmia syndromes
Session B (continued)
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J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
5:30 pm Room Koningssaal 6:00 pm The Philippe Coumel Lecture By Prof. Jeronimo Farre (Madrid, ES) A Brief History of the Exploration of the AV Junction 6:00 pm–7:00 pm Opening Ceremony Followed by a cocktail reception for all participants
MONDAY March 24, 2014 8:30 am 10:00 am
Room Konigssaal DT-04 The future of ICDs
Room Furstensalon SP-03 Clinical and technical challenges in mapping and ablation
Room Gelbersalon SP-04 Future of antiarrhythmic agents
Room Montgelassaal WS- 04 ECG pacemaker and CRT dysfunction E. Ovshyscher, C. Israel, B. Herweg E. Crystal
Room Palaishalle Chaired poster Session C
10:00 am–10:30 am: Coffee break and visit to Posters Time 10:30 am 12:00 pm
Simultaneous Oral Abstract sessions Room Room Room Room Room Konigssaal Furstensalon Gelbersalon Montgelassaal Palaishalle Oral abstract session 5 Oral abstract Oral abstract session 7 Oral abstract Chaired poster session 6 session 8 Session C 12:15 pm–1:45 pm 12:15 pm–1:45 pm Restaurant PALAISSTUBE Restaurant REFEKTORIUM Luncheon Panel 3 Luncheon Panel 4 Available Supported by an educational grant from Bayer Pharma AG Anticoagulation for Atrial Fibrillation
2:00 pm 3:30 pm
Room Konigssaal Session DT-05 CRT : Update on guidelines
Room Furstensalon SP-05 Catheter ablation of AF Various aspects of the procedure
Room Gelbersalon DT-06 Advances in device therapy
Room Montgelassaal SP-06 Translational Research in Electrophysiology
Room Palaishalle Chaired poster Session D
Coffee break 3:30 pm–4:00 pm and visit to Poster area Time 4:00 pm 5:30 pm
5:30 pm 7:00 pm
Simultaneous sessions Room Konigssaal SP-07 Ablation of frequent premature ventricular contractions (PVCs)
Room Konigssaal SP-11
Room Furstensalon Symposium
Room Gelbersalon SP-09
Room Montgelassaal SP-10
Room Palaishalle Chaired poster
SP-08
Russian Society of arrhythmology (RSA)
Innovations in AF ablation
Session D (continued)
7 th Japan HRS-ECAS Special session Y. Nakazato Room Furstensalon
A. Revishvili D. Shah Room Gelbersalon SP-12 ECAS-WSA
Room Montgelassaal
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119 Time
Simultaneous sessions Left atrial Ablation: Where do we stand after more than 10 years?
MA-03 Mechanisms of AF perpetuation
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Health technology assessment in CIEDs Electronic Devices M. Santini
SP-13 Patients at high risk of sudden cardiac death
TUESDAY MARCH 25, 2014 8:30 am 10:00 am
Room Watteau Oral abstract session 9 CRT
Room Furstensalon Oral abstract session 10 VT/VF
Room Gelbersalon Oral abstract session 11 AF progression and mechanisms
Room Montgelassaal Oral abstract session 12 Antiarrhythmics
Coffee break 10:30 am Room Watteau 12:00 pm SP-14 Silent AF
Room Furstensalon Room Gelbersalon Room Montgelassaal DT-07 WS-06 SP-15 Lead extraction: How did Techniques and tools for When a simple arrhythmia ablation I manage my worse case ? AF ablation turn into a complex case: N. Sulke-R. De Ponti How did I manage it
12:00 pm Room Furstensalon 12:30 pm Presentation of the Best Posters and Awards to the Awardees of the Best Abstracts
Abstract Oral Session 1: Risk factors, epidemiology and prevention of sudden cardiac death Sunday, March 23, 2014, 10:30 am–12:00 pm; ROOM KONIGSSAAL 1–1 Abstract 07–18 INCIDENCE, CHARACTERISTICS AND OUTCOME OF SUDDEN CARDIAC ARREST DURING SPORTS IN WOMEN Eloi Marijon1, Wulfran Bougouin1, Lionel Lamhaut1, Florence Dumas1, Jean-Yves Le Heuzey2, Jean-Philippe Empana1, Xavier Jouven1 1 Paris Cardiovascular Research Center, Paris, France, 2 Cardiology Department, European Georges Pompidou Hospital, Paris, France Background: No specific data are available on the characteristics and outcome of sudden cardiac death (SCD) during sport activities among women in the general population. Methods and results: From a prospective 5year national survey, involving 820 subjects aged 10– 75 years who presented with SCD (resuscitated or not) during competitive or recreational sport activities, 43
(5.2 %) such events occurred in women, principally during jogging, cycling and swimming. The level of activity at the time of SCD was moderate to vigorous in 35 cases (81.4 %). The overall incidence of sportrelated SCD, among 15–75-year-old women, was estimated as 0.59 (95%CI 0.39 to 0.79) to 2.17 (95%CI 1.38 to 2.96) per year per million female sports participants for the 80th and 20th percentiles of reporting districts, respectively. Compared to men, the incidence of SCD in women was dramatically lower, particularly in the 45–54 years range (relative risk 0.033, 95%CI 0.015 to 0.075). Despite very similar circumstances of occurrence, survival at hospital admission (46.6 %, 95%CI 31.0 to 60.0) was significantly higher than for men (30.0 %, 95 % 26.8–33.2, P=0.02), although this did not reach statistical significance for hospital discharge. Favorable neurological outcomes were similar (80 %). Cause of death appeared less likely to be associated with structural heart disease in women, compared to men (58.3 % vs. 95.8 %, P = 0.0003). Conclusions: Sports-related SCD in women participants appears dramatically less common (up to 30fold less frequent), compared to men. Our results also suggest a higher likelihood of successful resuscitation as well as la lower frequency of structural heart disease in women, compared to men.
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1–2 Abstract 07–11 SPORTS-RELATED SUDDEN CARDIAC DEATH IN A COMPETITIVE AND NON-COMPETITIVE ATHLETE POPULATION AGED 12–49 YEARS: DATA FROM A NATIONWIDE STUDY IN DENMARK Bjarke Risgaard1, Bo Gregers Winkel1, Reza Jabbari1, Charlotte Glinge1, Ole Ingemann-Hansen2, Jørgen Lange Thomsen3, Gyda Lolk Ottesen4, Stig Haunsø1, Anders Gaarsdal Holst1, Jacob Tfelt-Hansen1 1 Rigshospitalet, Copenhagen, Denmark, 2 Aarhus University, Aarhus, Denmark, 3University of Southern Denmark, Odense, Denmark, 4Copenhagen University, Copenhagen, Denmark Background: Sports-related sudden cardiac deaths (SrSCD’s) in athletes are tragic events. Data on SrSCD’s in competitive athletes >35 years are limited. We aimed to characterize all SrSCD’s aged 12– 49 years and to address the difference in incidence rates between competitive and non-competitive athletes. Methods: All deaths in Denmark in persons aged 12–49 years in 2007–2009 were included. Death certificates were reviewed. History of previous admissions to hospital was assessed, discharge summaries, and autopsy reports were read. Sudden cardiac deaths (SCD’s) and SrSCD cases were identified. Results: In the 3-year period, there were 881 SCD’s of which we identified 44 SrSCD’s. In non-competitive athletes, the incidence rate of SrSCD was 0.43 (95 % CI: 0.16 to 0.94) and 2.95 (95 % CI: 1.95 to 4.30) per 100,000 athlete person-years in those aged 12– 35 years and 36–49 years, respectively. In competitive athletes the incidence rate of SrSCD was 0.47 (95 % CI: 0.10 to 1.14) and 6.64 (95 % CI: 2.86 to 13.1) per 100,000 athlete person-years in those aged 12– 35 years and 36–49 years, respectively. The incidence rate of SCD in the general population was much higher. Most common cause of death was coronary artery disease (n = 15, 43 %) and several athletes (n = 30, 68 %) had possible cardiac symptoms prior to death of which angina was the most predominant (n = 17, 39 %) (Table 1). Conclusion: The incidence rate of SrSCD in non-competitive and competitive athletes is similar in the young. Importantly, SCD in the general population is much more prevalent than SrSCD. The present study suggests that preparticipation screening will be ethically problematic, if only provided to those (young people) involved in competitive sports. Raised awareness on cardiac symptoms prior to death is warranted.
J Interv Card Electrophysiol (2014) 39 (Suppl 1):S1–S119
Age group (years)
12–49
12–35
36–49
SrSCD cases (n)
44
9
35
Of whom were competitive athletes (n) Age group population, in thousands Active competitive athletes
11
3
8
2,735
1,618
1,116
8.9 %
13.2 %
3.6 %
Active non-competitive athletes Incidence rates per 100,000 person-years (denominator) SCD (general population)
28.1 %
28.7 %
27.3 %
(95 % CI)
(95 % CI)
(95 % CI)
10.7 (10.0–11.5) 3.15 (2.67–3.69) 21.7 (20.1–23.4)
SrSCD†(general population) 0.54 (0.39–0.72) 0.19 (0.08–0.35) 1.05 (0.73–1.45) Non-competitive athletes (non-competitive athletes) Competitive athletes (competitive athletes) Most common cause of death at autopsy, n (%) Coronary artery disease
1.43 (0.99–2.01) 0.43 (0.16–0.94) 2.95 (1.95–4.30)
15 (43)
2 (22)
13 (50)
Arrhythmogenic right ventricular cardiomyopathy Hypertrophic heart
5 (14)
3 (22)
2 (8)
4 (11)
–
4 (15)
Sudden unexplained death
4 (11)
2 (22)
2 (8)
Myocarditis
2 (6)
–
2 (8)
Other
5 (14)
2 (22)
3 (12)
Any possible cardiac symptom, n (%) Angina
30 (68)
5 (56)
25 (71)
17 (39)
1 (11)
16 (46)
Syncope
10 (23)
5 (56)
5 (14)
1.51 (0.75–2.71) 0.47 (0.10–1.14) 6.64 (2.86–13.1) 12–49 (n=35)
12–35 (n=9)
36–49 (n=26)
Dyspnoea
10 (23)
1 (11)
9 (26)
Other
16 (36)
3 (33)
13 (37)
Antecedent (
