SUDDEN CARDIAC ARREST DURING MASS RUNNING EVENTS IN THE CONTEXT OF THE 2025 EUROPEAN RESUSCITATION COUNCIL GUIDLINES AND CURRENT SCIENTIFIC EVIDENCE

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.