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Long QT syndrome type 1 (LQT1) has long been recognized as being associated with arrest while swimming, and a recent molecular autopsy study demonstrated that nearly 30% of swimming-related ��drowning�� was associated with LQT1 or another arrhythmogenic channelopathy (12). In our study cohort of patients experiencing SCA at exercise facilities, three-quarters were participating in high dynamic exercise activities compared with low dynamic exercise, as measured by the Bethesda Conference sports matrix classification. Survival of out-of-hospital SCA [http://www.selleckchem.com/products/abt-199.html ABT-199 purchase] varies greatly by location. Historically, overall survival rates of?[http://en.wikipedia.org/wiki/Bumetanide Bumetanide] of survival. In contrast to SCA at home, where survival rates of 12% do not approach the rate of 34% observed in public locations (21), survival rates at exercise sites appear to exceed survival at other public locations. In the PAD trial, a randomized study of PAD (22), survival was 35% at fitness centers, compared with 18% overall, although this only represented 24 events. We also observed a higher survival to hospital discharge among the patients with SCA at exercise sites (combined traditional and alternative) versus other indoor sites (49% vs. 34%; p?= 0.001). It is important that communities undertake [http://www.selleckchem.com/products/ABT-263.html Navitoclax] efforts to improve resuscitation from SCA (23). However, even with recognition of elevated risk for SCA at exercise facilities, the potential benefit of prompt resuscitation with an AED at these sites and the publication of recommendations from expert professional organizations, regulatory and voluntary compliance is incomplete. Our findings should encourage broader implementation of and adherence to recommendations and regulations for AED placement and SCA response protocols at traditional exercise facilities. In addition, these standards should be extended to alternative fitness facilities, where SCA site incidence rates are comparable to those at traditional exercise facilities. This was a retrospective study for which we only examined SCAs that occurred in an indoor public location. As such, we cannot infer results at outdoor exercise facilities or for patients who experienced a cardiac arrest shortly after they left the indoor location where they had been exercising. The study was not designed to include cases that occurred in the setting of exercising at home. Information regarding denominators for site incidence rates was not available for all location types.