Prevention of sudden cardiac death in athletes: new data and modern perspectives confront challenges in the 21st century.

The sudden death of a young athlete on the playing field remains the most devastating medical event in sports. The tragic impact of these events compels sports medicine professionals and sport governing bodies to develop and implement effective preventive strategies. In this issue, the British Journal of Sports Medicine and the International Olympic Committee (IOC) partner to present the most current information relevant to sudden cardiac death (SCD) in athletes. First in a series of quarterly BJSM-IOC issues devoted to injury prevention and health protection in athletes, this issue is dedicated to preventing the worst injury of all: sudden death. The objective of this issue is to highlight cardiovascular diseases in athletes through a compilation of commissioned reviews and original investigations authored by international experts in sports cardiology and sports medicine. The issue provides modern perspectives and recent data in the areas of epidemiology, diagnosis, screening and management. Prevention of SCD in athletes remains one of the most debated topics in sports medicine. What is the most appropriate strategy to screen athletes for underlying cardiovascular disease? Does the presence of automated external defibrillators (AEDs) at athletic events effectively treat young athletes who experience sudden cardiac arrest (SCA)? The complexities surrounding these questions are addressed in several reports presented in this issue. The screening debate is centred on the inclusion (or not) of a resting 12-lead electrocardiogram (ECG) in addition to a medical history and physical examination during the preparticipation athletic evaluation. At times, however, this global debate has stalled because of a continuing disagreement on the incidence of SCD in young athletes.