Sudden cardiac death in marathon runners: can it be prevented?

While several studies have reported an acute increase in the sudden death risk during running events, the benefits of regular exercise appear to outweigh the risks. Exercise test screening for middle-aged/senior leisure marathon runners has not proven to reduce SD; however, it appears to be prudent in the light of our current understanding of the cardiovascular risks and benefits of exercise in this age group. Competitors are recommended to take actions in order to avoid dehydration, sodium loss and the impact of heat on their body. Prompt defibrillation at the race by automated AED may be a valuable back-up for preventing unpredictable SD.