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Der Einfluß von körperlicher Aktivität auf die Inzidenz des plötzlichen Herztodes

The influence of physical activity on the incidence of sudden cardiac death. Examination of the population of Berlin-Reinickendorf and Berlin-Spandau

Untersuchung in der Bevölkerung von Berlin-Reinickendorf und Berlin-Spandau

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Zusammenfassung

□ Ziel

Die Arbeit untersucht den Einfluß regelmäßiger körperlicher Aktivität und akuter körperlicher Belastungssituationen auf die Inzidenz des plötzlichen Herztodes in der Bevölkerung von zwei Berliner Stadtteilen mit 219 251 Einwohnern in der untersuchten Altersgruppe.

□ Patienten und Methode

Alle plötzlichen Herztodesfälle außerhalb eines Krankenhauses mit dokumentiertem Kammerflimmern in der untersuchten Bevölkerung wurden über 18 Monate erfaßt und für jeden Betroffenen die regelmäßig absolvierte körperliche Aktivität und die Belastung bei Eintritt des plötzlichen Herztodes ermittelt. Mit den Daten über das Aktivitätsmuster der untersuchten Bevölkerung wurde die Inzidenz des plötzlichen Herztodes in Gruppen mit unterschiedlicher regelmäßiger körperlicher Belastung und das relative Risiko für den plötzlichen Herztod bei einer aktuellen körperlichen Belastungssituation im Vergleich zur Ruhe berechnet. Der Einfluß von Vorerkrankungen wurde ermittelt.

□ Ergebnisse

77 Patienten mit plötzlichem Herztod durch Kammerflimmern wurden eingeschlossen. In der Gruppe, die sich nie regelmäßig körperlich belastet, fand sich eine Inzidenz von 4,69 plötzlichen Herztoden/105 Personen-jahren, in der Gruppe mit niedriger regelmäßiger körperlicher Aktivität eine Inzidenz von 4,25, in der Gruppe mit mittlerer regelmäßiger körperlicher Aktivität eine Inzidenz von 2,63 und in der aktivsten Gruppe eine von 0,92 plötzlichen Herztoden/105 Personenjahren. Das relative Risiko für den plötzlichen Herztod bei Belastung im Vergleich zur Ruhe war in der Gruppe mit niedriger regelmäßiger körperlicher Aktivität 150 und in der aktivsten Gruppe 4. Die Vorerkrankungen der Fallgruppe hatten keinen Einfluß auf das Ergebnis.

□ Schlußfolgerung

Die Ergebnisse zeigen, daß für alle Menschen unabhängig von der gewohnten körperlichen Aktivität und den Vorerkrankungen anstrengende körperliche Belastung mit einem gegenüber der Ruhe deutlich erhöhten Risiko für den plötzlicher Herztod verbunden ist. Die Risikozunahme für den plötzlichen Herztod bei körperlicher Aktivität ist für Menschen mit einem passiven Lebensstil am stärksten, für Menschen mit einem aktiven Lebensstil am wenigsten ausgeprägt. Der protektive Effekt regelmäßiger körperlicher Aktivität für den plötzlichen Herztod übertrifft aber die Risikozunahme durch die aktuelle Belastungssituation.

Summary

□ Aim

Our investigation examined the influence of regular physical activity and sudden extrenious situations on the incidence of sudden cardiac death (scd) in two different Berlin districts with a total population of 219,251 in the examined agegroups.

□ Patients and Method

All cases of scd which occured outside of the hospital and were documented as been induced from ventricular fibrillation were examined over a time period of 18 months. For each case the amount of and the intensity of their regular physical activity was determined. In addition the stress of the sudden extrenious situations was survied. The study population was divided into various groups depending upon their level of regular physical activity. For each group the incidence of sudden cardiac death was determined.

The the relative risk for scd during strenuous activity compared to inactivity was determined for each group. The influence of preexisting disease was calculated.

□ Results

77 patients with scd induced from ventricular fibrillation were included in our study. In the sedentary group we found an incidence of 4.69 scd per 105 personyears, in the group with a low level of regular physical activity we found an incidence of 4.25, in the group with a middle level of regular physical activity an incidence of 2.63 and in the most active group 0.92 scd per 105 personyears.

We found the relative risk for scd during highly strenuous activity compared with inactivity to be 150 in the sedentary group as opposed to 4.0 in the most active group. The preexisting illness status of the case groups had no influence on the outcome.

□ Conclusions

The results show that the risk of scd for all persons regardless of their levels of regular physical activity and their preillness status is higher during strenuous activity than during inactivity. The increase of the risk for scd during activity is the highest for persons with sedentary lifestyles, whereas the risk increase for persons with active lifestyles is minimal. The protective effect of regular physical activity for scd by far exceeds the risk increase of the actual strenuous situation.

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Literatur

  1. Ainsworth, B. E., W. L. Haskell, A. S. Leon, D. R. Jacobs Jr, H. J. Montoye, J. F. Sallis, R. S. Paffenbarger Jr: Compendium of physical activities: classification of Energie costs of human physical activities. Med. Sci. Sports Exerc. 25 (1993), 71–80.

    Article  PubMed  CAS  Google Scholar 

  2. Barron, H. V., M. D. Lesh: Autonomic nervous system and sudden cardiac death. J. Amer. Coll. Cardiol. 27 (1996), 1053–1060

    Article  CAS  Google Scholar 

  3. Billmann, G. E., P. J. Schwartz, H. L. Stone: The effects of daily exercise on susceptibility to sudden cardiac death. Circulation 69 (1984), 1182–1189.

    Google Scholar 

  4. Blair, S. N., H. W. Kohl III, R. S. Paffenbarger, D. G. Clark, H. C. Kenneth, L. W. Gibbons: Physical fitness and all-cause mortality. A prospective study of healthy men and women. J. Amer. med. Ass. 262 (1989), 2395–2401.

    Article  CAS  Google Scholar 

  5. Blomqvist, C. G.: Cardiovascular adaptions to physical training. Ann. Rev. Physiol. 45 (1983), 169–189.

    Article  CAS  Google Scholar 

  6. Brady, H. R., M. Kinirons, T. Lynch, W. Tormey, K. M. O’Malley, J. H. Horgan: Heart rate and metabolic response to competitive squash in veteran players: identification of risk factors for sudden cardiac death. Europ. Heart J. 10 (1989), 1029–1035.

    CAS  Google Scholar 

  7. Chandrashekhar, Y., I. S. Anand: Exercise as a coronary protective factor. Amer. Heart J. 112 (1991), 1723–1739.

    Article  Google Scholar 

  8. Ciampricotti, R., M. E. Gamal, T. Relik, R. Taverne, J. Panis, J. de Swart, B. van Gelder, L. Relik-van Welly: Clinical characteristics and coronary angiographic findings of patients with unstable angina, acute myocardial infarction, and survivors of sudden ischemic death occuring during and after sport. Amer. Heart J. 120 (1990), 1267–1278.

    Article  PubMed  CAS  Google Scholar 

  9. Clausen, J. P.: Circulatory adjustments to dynamic exercise and effect of physical training in normal subjects and in patients with coronary artery disease. Progr. cardiovasc. Dis. 18 (1976), 459–495.

    Article  CAS  Google Scholar 

  10. Davies, M. J.: Anatomic features in victins of sudden coronary death. Coronary artery pathology. Circulation 85, Suppl. I (1992), 1-19–1-24.

    Google Scholar 

  11. Detry, J. M. R., M. Rousseau, G. Vandenbroucke, F. Kusumi, L. A. Brasseur, R. A. Bruce: Increased arteriovenous oxygen difference after physical training in coronary heart disease. Circulation 44 (1971), 109–118.

    PubMed  CAS  Google Scholar 

  12. Ekelund, L. G., W. L. Haskell, J. L. Johnson, F. S. Whaley, M. H. Criqui, D. S. Sheps: Physical fitness as a predictor of cardiovascular mortality in assymptomatic north american men. The Lipid Research Clinics Mortality Follow-up Study. New Engl. J. Med. 319 (1988), 1379–1384.

    PubMed  CAS  Google Scholar 

  13. Eshani, A. A., D. R. Biello, J. Schultz, B. E. Sobel, J. O. Holloszy: Improvement of left ventricular contractile function by exercise training in patients with coronary artery disease. Circulation 74 (1986), 350–358.

    Google Scholar 

  14. Falk, E.: Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Circulation 71 (1985), 699–708.

    PubMed  CAS  Google Scholar 

  15. Fletcher, G. F., S. N. Blair, J. Blumenthal, C. Caspersen, B. Chaitmann, S. Epstein, H. Fall, E. S. Sivarajan Froelicher, V. F. Froelicher, I. L. Pina: American Heart Association Medical/Scientific Statement: Statement on exercise. Benefits and recommendations for physical activity programs for all Americans. Circulation 86 (1992), 340–344.

    PubMed  CAS  Google Scholar 

  16. Friedewald, V. E., D. W. Spence: Sudden cardiac death associated with exercise: The risk-benefit issue. Amer. J. Cardiol. 66 (1990), 183–188.

    Article  PubMed  Google Scholar 

  17. Fuster, V., P. M. Steele, J. H. Chesebro: Role of platelets and thrombosis in coronary atherosclerotic disease and sudden death. J. Amer. Coll. Cardiol. 5 (1985), 175B-184B.

    CAS  Google Scholar 

  18. Fuster, V., B. Stein, J. A. Ambrose, L. Badimon, J. J. Badimon, J. H. Chesebro: Atherosclerotic plaque rupture and thrombosis. Circulation 82, Suppl. II (1990), II-47–II-59.

    CAS  Google Scholar 

  19. Garcia-Palmieri, M. R., R. Costas Jr, M. Cruz-Vidal, P. D. Sorlie, R. J. Havlik: Increased physical activity: A protective factor against heart attacks in Puerto Rico. Amer. J. Cardiol 50 (1982), 749–755.

    Article  PubMed  CAS  Google Scholar 

  20. Gillum, R. F.: Sudden coronary death in the United States 1980–1985. Circulation 79 (1989), 756–765.

    PubMed  CAS  Google Scholar 

  21. Goldberg, R. J.: Declining out-of-hospital sudden coronary death rates — additional pieces of the epidemiologic puzzle. Circulation 79 (1989), 1369–1373.

    PubMed  CAS  Google Scholar 

  22. Gomes, A., S. L. Winters, M. Martinson, J. Machac, D. Stewart, A. Targonski: The prognostic significance of quantitative signal-averaged variables relative to clinical variables, site of myocardial infarction, ejection fraction and ventricular premature beats: A prospective study. J. Amer. Coll. Cardiol. 13 (1989), 377–384.

    CAS  Google Scholar 

  23. Greenberg, M. A., S. Arbeit, I. L. Rubin: The role of physical training in patients with coronary artery disease. Amer. Heart J. 97 (1979), 527–534.

    Article  PubMed  CAS  Google Scholar 

  24. Hickey, N., R. Mulcahy, G. J. Bourke, I. Graham, K. Wilson-Davis: Study of coronary risk factors related to physical activity in 15171 men. Brit. med. J. 3 (1975), 507–509.

    Article  PubMed  CAS  Google Scholar 

  25. Hoffmeister, H., G. Mensink, H. Stolzenberg: Erfolgreiche Senkung kardiovaskulärer Risikofaktoren in der Deutschen Herz-Kreislauf-Präventionsstudie (DHP) zwischen 1984/85 und 1991/92. Z. Gesundh.-Wiss. 12 (1993), 83–94.

    Google Scholar 

  26. Hollmann, W., I. Gyárfas: Gesundheit und körperliche Aktivität. Dtsch. Ärztebl. 91 (1994), 2576.

    Google Scholar 

  27. Hossack, K. F., R. Hartwig: Cardiac arrest associated with supervised cardiac rehabilitation. J. card. Rehab. 2 (1982), 402–408.

    Google Scholar 

  28. Huttunen, J. K., E. Länsimies, E. Voutilainen, C. Ehnholm, E. Hietanen, I. Pentttila, O. Siitonen, R. Rauramaa: Effects of moderate physical exercise on serum lipoproteins. A controlled clinical trial with special reference to serum high-density lipoproteins. Circulation 60 (1979), 1220–1229.

    PubMed  CAS  Google Scholar 

  29. Irving, J. B., R. A. Bruce: Exertional hypotension and postexertional ventricular fibrillation in stress testing. Amer. J. Cardiol. 39 (1977), 849–851.

    Article  PubMed  CAS  Google Scholar 

  30. James, N. J.: Summary thoughts about sudden cardiac death. J. Amer. Coll. Cardiol. 5 (1985), 192B-198B.

    Article  Google Scholar 

  31. Kannel, W. B., P. Sorlie: Some health benefits of physical activity. The Framingham Study. Arch. intern. Med. 139 (1979), 857–861.

    Article  PubMed  CAS  Google Scholar 

  32. Kendall, M. J., K. P. Lynch, Å. Hjalmarson, J. Kjekshus: β-blockers and sudden cardiac death. Ann. intern. Med. 123 (1995), 358–367.

    PubMed  CAS  Google Scholar 

  33. Kulbertus, H. E., S. Nisam: The implantable defibrillator AICD: European clinical experience. In: Brugada, P., H. J. Wellens: Sudden cardiac death. Developments in cardiovasc. medicine. Vol. 110. Kluwer. Netherlands 1990, p. 681–686.

    Google Scholar 

  34. Kuller, L., M. Cooper, J. Perper: Epidemiology of sudden death. Arch. intern. Med. 129 (1972), 714–719.

    Article  PubMed  CAS  Google Scholar 

  35. Leon, A. S., J. Conett, D. R. Jacobs, R. Rauramaa: Leisuretime physical activity and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial. J. Amer. med. Ass. 258 (1987), 2388–2395.

    Article  CAS  Google Scholar 

  36. Liberthson, R. R., E. L. Nagel, J. C. Hirschmann, S. R. Nussenfeld, B. D. Blackbourne, J. H. Davis: Pathophysiologic observations in prehospital ventricullar fibrillation and sudden cardiac death. Circulation 49 (1974), 790–798.

    PubMed  CAS  Google Scholar 

  37. Marti, B., S. Goerre, T. Spuhler, T. Schaffner, F. Gutzwiller: Plötzliche Todesfälle an Schweizer Volksläufen 1978–1987: eine epidemiologisch-pathologische Studie. Schweiz. med. Wschr. 119 (1989), 473–482.

    PubMed  CAS  Google Scholar 

  38. Mittlemann, M. A., M. Maclure, G. H. Toffler, J. B. Sherwodd, R. J. Goldberg, J. E., J. E. Muller: Triggering of acute myocardial infarction by heavy physical exertion. New Engl. J. Med. 329 (1993), 1677–1683.

    Article  Google Scholar 

  39. Moritz, A. R., N. Zamcheck: Sudden and unexpected death of young soldiers. Arch. Path. 42 (1946), 459–494.

    CAS  PubMed  Google Scholar 

  40. Morris, C. K., V. F. Froelicher: Cardiovascular benefits of physical activity. Herz 16 (1991), 222–236.

    PubMed  CAS  Google Scholar 

  41. Morris, J. N., S. P. W. Chave, C. Adam, C. Sirey: Vigorous exercise in leisure-time and the incidence of coronary heart-disease. Lancet 1 (1973), 333–339.

    Article  PubMed  CAS  Google Scholar 

  42. Morris, J. N., D. G. Clayton, M. G. Everitt, A. M. Semmence, E. H. Burgess: Exercise in leisure time: coronary attack and death rate. Amer. Heart J. 63 (1990), 325–334.

    CAS  Google Scholar 

  43. Muller, J. E., G. S. Abela, R. W. Nesto, G. H. Tofler: Triggers, acute risk factors and vulnerable plaques: The lexicon of a new frontier. J. Amer. Coll. Cardiol. 23 (1994), 809–813.

    CAS  Google Scholar 

  44. Myerburg, R. J., K. M. Kessler, A. Castellanos: Sudden cardiac death. Structure, function, and time-dependence of risk. Circulation 85, Suppl. I (1992), I-2–I-10.

    CAS  Google Scholar 

  45. Myerburg, R. J., K. M. Kessler, A. Castellanos: Sudden cardiac death. Epidemiology, transient risk and intervention assessment. Ann. intern. Med. 119 (1993), 1187–1197.

    PubMed  CAS  Google Scholar 

  46. Nisam, S., S. A. Kaye, M. M. Mower, M. Hull: AICD automatic cardioverter defibrillator clinical update: 14 years experience in over 34.000 patients. Pacing clin. Electrophysiol. 18 (1995), 142–147.

    Article  CAS  Google Scholar 

  47. Noakes, T. D., L. Higgison, L. H. Opie: Physical training increases ventricular fibrillation tresholds of isolated rat hearts during normoxia, hypoxia and reginal ischemia. Circulation 67 (1983), 24–30.

    PubMed  CAS  Google Scholar 

  48. O’Connor, G. T., J. E. Buring, S. Yusuf, S. Z. Goldhaber, E. M. Olmstead, R. S. Paffenbarger, C. H. Hennekens: An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 80 (1989), 234–244.

    PubMed  Google Scholar 

  49. Opie, L. H.: Sudden death and sport. Lancet 1 (1975), 263–266.

    Article  PubMed  CAS  Google Scholar 

  50. Paffenbarger, R. S., W. E. Hale: Work activity and coronary heart mortality. New Engl. J. Med. 292 (1975), 545–550.

    Article  PubMed  CAS  Google Scholar 

  51. Paffenbarger, R. S., R. T. Hyde, A. L. Wing, C. C. Hsieh: Physical activity, all-cause mortality and longevity of college alumni. New Engl. J. Med. 314 (1986), 605–613.

    Article  PubMed  Google Scholar 

  52. Paffenbarger, R. S., R. T. Hyde, A. L. Wing, C. H. Steinmetz: A natural history of athleticism and cardiovascular health. J. Amer. med. Ass. 252 (1984), 491–495.

    Article  Google Scholar 

  53. Paffenbarger, R. S., R. T. Hyde, A. L. Wing, I. Lee, D. L. Jung, J. B. Kampert: The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. New Engl. J. Med. 328 (1993), 538–545.

    Article  PubMed  Google Scholar 

  54. Paffenbarger, R. S., A. L. Wing, R. T. Hyde: Physical activity as an index of heart attack risk in college alumni. Amer. J. Epidem. 108 (1978), 161–175.

    Google Scholar 

  55. Pashkow, F. J.: Issues in contemporary cardiac rehabilitation: Historical perspective. J. Amer. Coll. Cardiol. 21 (1993), 822–834.

    Article  CAS  Google Scholar 

  56. Pedretti, R., A. Laporta, S. Braga, B. Caru: Prediction of late arrhythmic event after acute myocardial infarction from combined use of noninvasive prognostic variables and inducibility of sustained monomorphic ventricular tachycardia. Amer. J. Cardiol. 71 (1993), 1131–1141.

    Article  PubMed  CAS  Google Scholar 

  57. Pekkanen, J., B. Marti, A. Nissinen, J. Tuomilehto: Reduction of premature mortality by high physical activity: A 20-year follow-up of middle-aged finnish men. Lancet 1 (1987), 1473–1477.

    Article  PubMed  CAS  Google Scholar 

  58. Perper, J., L. Kuller, M. Cooper: Ateriosclerosis of coronary arteries in sudden, unexpected deaths. Circulation 52 (1975), III:27–33.

    Google Scholar 

  59. Pitt, B.: The role of β-adrenergic blocking agents in preventing sudden cardiac death. Circulation 85, Suppl. I (1992), I107-I111.

    PubMed  CAS  Google Scholar 

  60. Podrid, R. J.: Role of higher nervous acticity in ventricular arrhytmia and sudden cardiac death: implications for alternative antiarrhytmic therapy. Ann. N. Y. Acad. Sci. 432 (1984), 296–313.

    Article  PubMed  CAS  Google Scholar 

  61. Rauramaa, R.: Relationship of physical activity, glucose toleranz, and weight management. Prev. Med 13 (1984), 37–46.

    Article  PubMed  CAS  Google Scholar 

  62. Rosseau, M. F., L. A. Brasseur, J. M. Detry: Henodynamic determinants of maximal oxygen intake in patients with healed myocardial infarction: influence of physical training. Circulation 48 (1973), 943–951.

    Google Scholar 

  63. Sandvik, L., J. Erikssen, E. Thaulow, G. Erikssen, R. Mundal, K. Rodahl: Physical fitness as a predictor of mortality among healthy, middleaged Norwegian men. New Engl. J. Med. 328 (1993), 533–537.

    Article  PubMed  CAS  Google Scholar 

  64. Schaible, T. F., J. Scheuer: Cardiac adaptions to chronic exercise. Progr. cardiovasc. Dis. 27 (1985), 297–316.

    Article  CAS  Google Scholar 

  65. Schwartz, P. J., M. T. La Rovere, E. Vanoli: Autonomic nervous system and sudden cardiac death. Circulation 85, Suppl. I (1992), I-77–I-91.

    CAS  Google Scholar 

  66. Seals, D. R., P. B. Chase: Influence of physical training on heart rate variability and baroreflex circulatory control. J. appl. Physiol. 66 (1989), 1886–1895.

    Article  PubMed  CAS  Google Scholar 

  67. Seals, D. R., J. M. Hagberg: The effect of exercise training on human hypertension: a review. Med. Sci. Sports Exerc 16 (1984), 207–215.

    Article  PubMed  CAS  Google Scholar 

  68. Shaper, A. G., G., Wannamethee: Physical activity and ischaemic heart disease in middle-aged british men. Brit. Heart J. 66 (1991), 384–394.

    Article  PubMed  CAS  Google Scholar 

  69. Siscovick, D. S., N. S. Weiss, R. H. Fletcher, T. Lasky: The incidence of primary cardiac arrest during vigorous exercise. New Engl. J. Med. 311 (1984), 874–877.

    Article  PubMed  CAS  Google Scholar 

  70. Siscovick, D. S., N. S. Weiss, A. P. Hallstrom, T. S. Inui, D. R. Peterson: Physical activity and primary cardiac atrest. J. Amer. med. Ass. 248 (1982), 3113–3117.

    Article  CAS  Google Scholar 

  71. Slattery, M. L., D. R. Jacobs, M. Z. Nichamann: Leisure time physical activity and coronary heart diesease death. The US Railroad Study. Circulation 79 (1989), 304–311.

    PubMed  CAS  Google Scholar 

  72. Speiser, W., W. Langer, A. Pschaick, E. Selmayr, B Ibe, P. E. Nowacki, G. Müller-Berghaus: Increased blood fibrinolytic activity after physical exercise: Comparative study in individuals with different sporting activities and in patients after myocardial infarction taking part in a rehabilitation sports program. Thrombos. Res. 51 (1988), 543–555.

    Article  CAS  Google Scholar 

  73. Thompson, P. D., E. J. Funk, R. A. Carleton, W. Q. Sturner: Incidence of death during jogging in Rhode Island from 1975 through 1980. J. Amer. med. Ass. 247 (1982), 2535–2538.

    Article  CAS  Google Scholar 

  74. Tran, Z. V., A. Weltmann: Differential effects of exercise on serum lipid and lipoprotein levels seen with changes in body weight. A meta-analysis. J. Amer. med. Ass. 254 (1985), 919–924.

    Article  CAS  Google Scholar 

  75. Vuori, I.: The cardiovascular risk of physical activity. Acta med. scand. Suppl. 711 (1986), 205–214.

    CAS  Google Scholar 

  76. Willich, S. N., D. Levy, M. B. Rocco, G. H. Tofler, P. H. Stone, J. E. Muller: Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population. Amer. J. Cardiol. 60 (1987), 801–806.

    Article  PubMed  CAS  Google Scholar 

  77. Willich S. N., R. J. Goldberg, M. Maclure, L. Periello, J. E. Muller: Increased onset of sudden cardiac death in the first three hours after awakening. Amer. J. Cardiol. 70 (1992), 65–68.

    Article  PubMed  CAS  Google Scholar 

  78. Willich, S. N., M. Maclure, M. Mittlemann, H. R. Arntz, J. E. Muller: Sudden cardiac death. Support for a role of trigering in casuation. Circulation 87 (1993), 1442–1450.

    PubMed  CAS  Google Scholar 

  79. Willich, S. N., L. Lewis, H. Löwel, H. R. Arntz, F. Schubert, R. Schröder: Physical exertion as a trigger of acute myocardial infarction. New Engl. J. Med. 329 (1993), 1684–1690.

    Article  PubMed  CAS  Google Scholar 

  80. Winkle, R. A., A. Thomas: The automatic implantable cardioverter defibrillator: The US experience. In: Brugada, P., H. J. J. Wellens: Sudden cardiac death. Developments in cardiovasc. medicine. Vol. 110, Kluwer, Netherlands 1990, 663–680.

    Google Scholar 

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  1. I. Innere Abteilung, Humboldt-Krankenhaus, Am Nordgraben 2, D-13509, Berlin

    Ralf Bartels, Marlies Menges & Walter Thimme

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Bartels, R., Menges, M. & Thimme, W. Der Einfluß von körperlicher Aktivität auf die Inzidenz des plötzlichen Herztodes. Med Klin 92, 319–325 (1997). https://doi.org/10.1007/BF03044770

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