Sudden cardiac death in athletes is an uncommon but extremely visible event 
because of the high profile of amateur and professional athletes and the 
expected excellent health of these athletes. However, paradoxically, athletic 
performance may immediately increase the risk of ventricular arrhythmias and 
sudden cardiac death while run reducing atherosclerosis, which thus improves 
cardiovascular health and longevity. In athletes younger than 30 years, the most 
common underlying causes are due to inherited heart disease. In the older 
athletes, sudden death is generally due to arrhythmias in the context of 
coronary artery disease. Many athletes with aborted sudden death, 
arrhythmia-related syncope, or high-risk genetic disorders benefit from therapy 
with implanted cardioverter/defibrillators (ICDs) . Although ICD therapy can 
effectively abort sudden death, implantation of an ICD generally prohibits an 
individual from all competitive athletics except low-intensity sports. The 
screening of athletes has been notoriously inadequate; however, the optimal 
screening strategies have yet to be determined. Recommendations for 
participation in competitive athletics generally follow the recently published 
36th Bethesda Conference Eligibility Recommendations for Competitive Athletes 
with Cardiovascular Abnormalities.