Rowing takes stand to reduce heart risks

FISA is introducing a pre-competition health screening process that  will be introduced in stages. This screening process has been designed by experts to identify as accurately as possible athletes that may be at risk of heart problems and advise them accordingly. In 2014 screening will apply for all rowers competing in the 2014 World Rowing Junior Championships. In 2015 screening will apply to all rowers competing in the Junior, Under-23 and Senior World Championships. For all other events including masters, coastal, indoor and touring screening of rowers is strongly recommended.  

The required screening is based on the International Olympic Committee’s (IOC) Pre-Competition Health Screening which follows on from the finding that the leading cause (more than 90 per cent) of non-traumatic sudden death in athletes is related to pre-existing heart problems.

IOC Medical and Scientific Director Richard Budgett, a 1984 Olympic gold medallist rower, praised FISA’s stand stating, “The IOC published a consensus statement on Periodic Health Examination in 2009 as part of its strong commitment to protect the health of athletes. The introduction by FISA of mandatory pre-competition health screening is an excellent initiative that puts into practice the principles of the consensus statement.

“The new bye-law promotes good medical practice throughout the sport of rowing and thus is a significant step forward in the protection of athletes’ health.”

Olympic medallist Greg Searle of Great Britain found out about his heart condition through pre-competition screening when he went to compete in an Italian triathlon late last year. Searle won gold at the 1992 Olympic Games and then made a comeback in 2010 competing in his country’s men’s eight at the London 2012 Olympics. While in Italy, which has compulsory screening, Searle was screened. The results showed that he had atrial fibrillation – a condition that also affected British Olympic Champion Tom James while he was training for the London Olympics.

A step test during screening saw Searle’s heart beat jump to 240 beats per minute. Consequently Searle was not allowed to compete in the triathlon. “I’ve had electric shock which has put my heart back into rhythm,” says Searle. “So it’s normal now but I have to be careful.” Searle has had no incident since but has been advised to be careful with alcohol intake and also in doing endurance sport.

Both Searle’s father and uncle have the same heart problem and Searle has been prescribed Warfarin, a blood thinner. If Searle had not been screened the consequence could have been a stroke.

FISA sports medicine commission member Dr. Juergen Steinacker who specialises in cardiology is aware of heart conditions in rowers. Recently 2012 Olympic Champion Nathan Cohen of New Zealand discovered that he had supraventricular tachycardia (SVT). This is when the rhythm of the heart suddenly changes.

“It can impact on rowing performance and make patients uncomfortable but by itself it is not life-threatening,” says Steinacker. For Cohen, who was 27 when the condition occurred, it meant not competing at the 2013 World Rowing Championships.

“It feels like your oxygen is running out, you lose power and become weaker, like you’re dragging something behind the boat,” Cohen told the New Zealand Herald at the time.

“When an athlete gets older they can get an absolute arrhythmia (irregular heartbeat of the atria by dysfunction of sinus node) which is different from Nathan’s condition. The risk is somehow higher in athletes than the general population. But despite this rowers have a high life expectancy,” says Steinacker. “Normally arrhythmia problems don’t have a genetic trait. So you can’t say whether your son or daughter will have it as it’s to do with the development of the heart. It can occur from hypertrophic heart walls, a condition when arterial hypertension is not treated or from previous viral infections.”

New Zealand rower Rob Waddell very famously moved into single sculling after he was diagnosed with heart problems (arterial fibrillation). Waddell did not want to be in a team boat and potentially let his team mates down so he changed to the single. He went on to win gold at the Sydney 2000 Olympics. However when Waddell attempted a comeback in the single in 2008 his heart let him down. In a head-to-head race with Mahe Drysdale to help decide who would be chosen as New Zealand’s Olympic single sculler, Waddell was barely able to finish the 2000m race.

Waddell went on to compete at the Beijing Olympics in the men’s double. Then in 2009 he had an operation to correct his heart problems.

Steinacker says studies have shown that the mandatory screening done in Italy has meant the rate of SCD has diminished by 50 per cent. “In most cases of athletes dying of SCD it has been unnecessary. You can’t prevent everything but you can prevent SCD.”

FISA sports medicine commission member Dr. Mike Wilkinson adds that most heart conditions are pre-existing. The most common is hypertrophic cardiomyopathy. “Very often an athlete can continue for their whole career and never know that they have a predisposition, or the first time they know is when they collapse.”

“If screening is done,” says Wilkinson, “then it’s the most cost effective way of picking up abnormalities.”