Mobile AED systems during mass running events achieved 100% on-site ROSC with median time to first shock of 2 minutes and favorable neurological outcomes in all cases.
Advances in emergency planning, AED availability, and emerging technologies like smartwatch detectors and GPS coordination are improving survival rates for sudden cardiac arrest during mass running events.
Effect estimate: Median time to first defibrillation shock 2 minutes; median time to ROSC under 6 minutes; 100% ROSC on site in intervention cases
Introduction and objective: Sudden cardiac arrest (SCA) during outdoor sport training is a complication where a quick response from medical professionals is crucial for increasing chances of survival. In parallel with the global growth in running events, there is a need to implement new recommendations and technologies to improve prevention, detection, and treatment of SCA among runners. Review Methods: A comprehensive literature review was conducted, analyzing studies indexed in PubMed, Google Scholar, and the official ERC Guidelines from 2021 and 2025. Key findings: Recent data suggest that, although the number of SCA cases in mass running events has remained relatively stable over the past decade, running-related deaths have declined. These outcomes are likely attributable to significant improvements in emergency action planning, widespread AED availability, and enhanced first-aid education. There are also new ideas that can further improve those outcomes, not only in treatment but also in SCA prophylaxis. New preventive and diagnostic strategies, such as point-of-care blood gas analysis (POC BGA) and risk-profiling patient triage, focus primarily on early triage and smartwatch pulse-detector systems, offering a new perspective on more rapid detection of SCA during outdoor activity. Advances in treatment focus on optimizing the prehospital chain of survival through mobile AED teams, GPS-enabled responder coordination, and structured “field-of-play” protocols. Further research is needed to reduce the time to defibrillation and improve neurological outcomes during endurance events.
Czaplińska-Paszek et al. (Wed,) conducted a review in Runners participating in mass endurance running events such as marathons and half-marathons, predominantly male older athletes at higher risk of sudden cardiac arrest. Mobile AED systems with rapid CPR and defibrillation vs. Standard medical coverage for running events was evaluated on Survival with return of spontaneous circulation (ROSC) and favorable neurological outcomes after sudden cardiac arrest during running events (Median time to first defibrillation shock 2 minutes; median time to ROSC under 6 minutes; 100% ROSC on site in intervention cases). Mobile AED systems during mass running events achieved 100% on-site ROSC with median time to first shock of 2 minutes and favorable neurological outcomes in all cases.