Abstract 227: Sudden Cardiac Arrest During Exercise Occurs Infrequently and With Few Warning Symptoms
Bibliographic record
Abstract
Introduction: The incidence and details of sudden cardiac arrest (SCA) during exercise in the general population are not well described. We describe a cohort ages 2-85 who experienced an SCA within ≤ 1 hour of moderate to vigorous activity in 4 metropolitan areas of British Columbia, Canada. Methods: We reviewed prehospital records of consecutive out-of-hospital cardiac arrests (OHCAs) in the provincial BC OHCA Registry from June 17 2017 to August 16 2018. We included non-traumatic OHCAs treated by EMS occurring within ≤ 1 hour of exercise. We defined SCA as an OHCA of no obvious cause, witnessed/unwitnessed, survived/died. We assigned an estimated metabolic equivalent (MET) score to each type of physical activity. We defined moderate exercise as a MET score of 3-5.9 and vigorous as ≥6. Results: A total of 2674 OHCAs occurred during the study period of which 56 SCAs (2.1%) occurred within ≤1 hour of participation in 23 types of exercise (Figure 1). The incidence of SCA during exercise was 1.45 (95% CI 1.10-1.88) per 100,000 population. The median age was 56.5 [IQR 45-69] and 87.5% (49/56) were male. Most exercise related SCAs occurred in public (49/56 87.5%), 83.3% (45/54) were bystander witnessed and 85% (46/54) received bystander CPR. Over 70% (40/56) had a shockable rhythm. The survival rate was 55.4% (31/56). Half of the SCAs collapsed during exercise (49.1%; 26/53) while the other half collapsed within ≤1 hour after exercising (51%; 27/53). Symptom data were available in 46% of patients (23/50) with most experiencing chest pain, dizziness, feeling unwell or seizure just prior to collapse. Conclusions: SCAs during exercise are rare and frequently occur in a public location. Survival is high and may be related to witnessed and public location status. Equal numbers of SCAs collapsed during or ≤ 1 hour of exercising and symptoms were present in almost half. Future research is needed to determine what factors could predict those at highest risk for SCA in order to prevent future events.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".