Athletes Chest Pads Won't Stop Fatal Heart Injury

Chest protectors used in baseball and other sports are unlikely to prevent children from suffering a rare but catastrophic injury to the heart, new research suggests.

In lab tests of 12 chest protectors on the market, researchers found no evidence that the gear would prevent a child from going into cardiac arrest after a blow to the chest from a hard ball or puck.

An estimated 10 to 20 people die each year in such incidents, most often in baseball, but also in lacrosse and hockey. Children and younger teens, with their narrow, underdeveloped chests, are most at risk.

These fatal injuries are uncommon because they require a blunt force directly over the heart at a particular, narrow window of time in the heart's rhythmic cycle.

But if those circumstances come together, a child can go into cardiac arrest due to ventricular fibrillation (VF) - a malfunction of the heart's electrical system that causes its main pumping chambers to quiver chaotically.

Unless a normal heart rhythm is restored with a defibrillator, the victim can die within minutes.

There is evidence that so-called safety balls, which make a softer impact, can cut children's risk of VF. But the same does not appear true of chest protectors, according to the new findings, published in the journal Pediatrics.

"I don't advocate using a chest wall protector, because I don't see evidence that they help," said study co-author Dr. Mark S. Link, an associate professor of medicine at Tufts University School of Medicine in Boston.

Chest protectors were originally designed to prevent bruising, not VF and sudden death, and Link told Reuters Health that he doesn't blame manufacturers for the gear's shortcomings.

But he said he hopes companies will use research such as this to design chest protectors that can help prevent these fatal accidents.

For their study, Link and his colleagues assessed 12 different brands of chest protector used in baseball and lacrosse. Using pigs that were anesthetized, the researchers tested whether the equipment could prevent VF in animals that were struck by a ball directly over the heart.

They found that animals outfitted with a chest protector were no less likely to go into VF than those that had no protective gear.

It's still not clear, Link said, what design changes might make chest protectors effective against cardiac arrest.

For now, parents can help protect their children by using safety balls for backyard games. Though many people think of these balls as spongy toys meant for young children, Link said they actually come in "age-appropriate" variations that are simply softer than standard baseballs, and can be used by kids as old as 13.

Another key safety measure, Link said, is to have portable, layperson-friendly defibrillators on the sidelines at games and practices.

What parents should not do, according to Link, is keep their children out of baseball or other sports because of this risk. "This is not meant to scare people," he said, noting that his own kids play baseball and lacrosse.

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