Key Facts
- STUDY TYPE: Prospective Cohort Study
- FIELD: Sports Cardiology
- STATUS: Planning Phase
- START: Spring 2026
- PARTICIPANTS: Elite and Recreational Athletes
Background & Rationale
Why ORCCA-Europe matters
By co-operating with professional and elite athletes, our team aims to contribute complete outcome data. ORCCA Europe supports better shared decision-making, tracks heart health outcomes, monitors physical activity, and assesses overall quality of life in athletes with cardiac conditions.
ORCCA-Europe: Building Evidence for Safe Return to Sport
The project studies return-to-sport decisions in competitive athletes aged 18 to 35 with cardiovascular conditions. In addition, it tracks major adverse cardiovascular events, exercise habits, and psychosocial well-being. Our goal is to create a strong evidence base for future guidelines. Because prospective data are limited, this project is highly relevant. Our team contributes to this effort in Europe to support evidence-based and patient-centered sports cardiology care.
Sudden Cardiac Arrest in Young Athletes
Sudden cardiac arrest (SCA) is the main cause of sudden cardiac death in young competitive athletes (1,2). In most cases, it is linked to genetic or structural heart disease. Therefore, early sports cardiology guidelines introduced a strict classification system. Athletes were labeled as either fit or unfit for sport, based on their diagnosis (3).
Organizations such as the American Heart Association (AHA) and the European Society of Cardiology (ESC) later developed formal recommendations for athletes with cardiovascular disease (4,5).
The Need For Prospective Data and Shared Decision-Making
However, many current recommendations still rely on expert opinion and past data. As a result, clinical decisions often lack strong forward-looking evidence. Recent studies suggest some athletes with heart disease may safely continue competitive sports. However, these studies are limited by small sample sizes, selected groups, and their retrospective design. (6,7).
At the same time, cardiovascular risk factors are more common than actual cardiac events. In addition, disqualification from sport can cause significant psychosocial harm. Therefore, updated AHA and ESC guidelines now emphasize individualized and shared decision-making (8).
Resources
(1) Harmon KG, Drezner JA, Wilson MG, Sharma S. (2014). Incidence of sudden cardiac death in athletes: a state-of-the-art review. British Journal of Sports, 100:1219-1220.
(2) Bohm P, Meyer T, Narayanan K, Schindler M, Weizman O, Beganton F, Schmied C, Bougouin W, Barra S, Dumas F, Varenne O, Cariou A, Karam N, Jouven, X, Marijon, E. (2023). Sports-related sudden cardiac arrest in young adults. Europace, 25:627–633.
(3) Mitchell JH, Maron BJ, Epstein SE. (1984). 16th Bethesda conference: cardiovascular abnormalities in the athlete: recommendations regarding eligibility for competition. J Am Coll Cardiol., 1985(6):1186–1232.
(4) Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, et al. (2021). 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J., 42:17-96.
(5) Maron BJ, Zipes DP, Kovacs RJ. (2015). Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: preamble, principles, and general considerations: a scientific statement from the American Heart Association and American College of Cardiology. Circulation, 132:256-261.
(6) Pelliccia A, Caselli S, Pelliccia M, Musumeci MB, Lemme E, Di Paolo FM, Maestrini V, Russo D, Limite L, Borrazzo C, et al. (2020). Clinical outcomes in adult athletes with hypertrophic cardiomyopathy: a 7‐year follow‐up study. Br J Sports Med., 54:1008-1012.
(7) Turkowski KL, Bos JM, Ackerman NC, Rohatgi RK, Ackerman MJ. (2018). Return‐to‐play for athletes with genetic heart diseases. Circulation., 137:1086-1088.
(8) Baggish AL, Ackerman MJ, Lampert R. (2017). Competitive sport participation among athletes with heart disease: a call for a paradigm shift in decision making. Circulation,136:1569-1571.