Healthy Heart Guidelines

A number of prominent cardiac events have occurred within the rowing community throughout 2025. This has drawn attention to the importance of education for our community with regards to optimising heart health across the rowing lifespan. 

There has been ongoing work lead by RA’s Principal Medical Officer Dr Larissa Trease with regards to heart health, in the particular the following has been implemented: 

• Engagement with Professor Andre La Gerche, Sports Cardiologist and researcher to provide advice and education 
• Specific education piece on RA website with Professor La Gerche 

• Revision of the RA Cardiac Screening Guidelines to be the RA Health Heat Guidelines (attached) with increased emphasis on emergency response to cardiac issues and AED access as well as highlighting importance of awareness of AF. The RA Health Heart Guidelines will replace the RA Cardiac Screening Guidelines on the RA website. 

• Inclusion of healthy heart education session at the Level 3 Coaches Course being held this week.  

There are additional planned actions to be implemented in the coming months which include: 

• Webinar for Rowing community members on heart health and specifically AF with Professor La Gerche late in 2025. 

• Investment in AED equipment to ensure that all RA teams travel with portable, appropriate equipment for emergency response 

• Improved cardiac screening consent process and dedicated cardiac screening process at pathway trials to ensure best practice in ECG screening (previously done through private providers and at athlete cost) 

RA is also delivering on initiatives to contribute to improved understanding of the impact of rowing on the heart: 

• Promotion of the Prospective Athlete Heart Study in the rowing community 
• Creation of a cardiac health register for RA HP program (Snr/ U23/ U19 athletes) 

RA Healthy Heart Guidelines

Rowing is a sport for life that is accessible to people of all ages, genders, fitness and skill levels, and is enjoyed by participants ranging from young rowers at school through to those at universities and in the wider club community through to masters rowing.

Rowing is an excellent way for individuals to stay active and to experience the health benefits of physical activity in an enjoyable and social environment. Exercise remains one of the most powerful tools for long-term health, and the health benefits of rowing far outweigh any health risks.

However, there are several cardiac specific concerns for rowers, which Rowing Australia (RA) would like to draw the community’s attention to:

1. Early Cardiac Response (CPR) Recommendations for Clubs and Schools

 Australian rowing clubs and schools should consider implementing an AED (automatic external defibrillator) device and protocol within the club environment for all training sessions and activities at the club or run by the club. Clubs, schools and all training environments should have guidelines for administering first aid to a collapsed athlete, and club members (particularly coaches) should be trained and practiced in the use of the AED. The AED needs to be accessible from general club spaces, with the location known to all members.  

How to SAVE a LIFE - Recognize Sudden Cardiac Arrest in Athletes

 2. Cardiac health across the rowing lifespan

Cardiovascular disease

 Unlike younger athletes, where cardiac issues are often linked to congenital or structural heart abnormalities, in rowers aged 45+ it is more commonly associated with atherosclerotic plaque rupture during intense physical exertion. While regular exercise is generally protective for heart health, sudden bouts of high-intensity activity— especially in rowers with undiagnosed or unmanaged cardiovascular risk factors such as hypertension, hyperlipidemia, smoking history, or diabetes—can act as a trigger for cardiac events. Whilst not mandatory, it is prudent that participants at all levels of Australian rowing ensure that they are physically fit to compete in rowing training and competition.

 Atrial Fibrillation

Recent research has identified that Atrial Fibrillation (AF), a non-life threatening cardiac arrythmia is more common in highly trained endurance athletes, in particular in retired elite rowers. Understanding AF in endurance athletes.  

Members of the Rowing community should be cognisant that AF can be asymptomatic and any symptoms, such as palpitations or a fluttering in the chest, breathlessness or fatigue during exercise should be investigated with the athlete’s Medical Practitioner.

RA has a medical network which includes GPs, Sport and Exercise Physicians and Sports Cardiologists who are experience in the identification and management of all health conditions in the rower.  3. Cardiac screening for elite athletes The leading cause (more than 90%) of non-traumatic sudden death in athletes is related to a pre-existing cardiac abnormality. In 2015, World Rowing introduced a mandatory cardiovascular pre-competition health screening for competitors at Under-19, Under-23 and Senior World Championships. The purpose of this screening is to identify, as accurately as possible, athletes at risk to advise them accordingly.

Consistent with this position, RA (and/or via the NIN and HP Club Performance Pathway Partners) shall conduct pre-competition health screening which complies with the World Rowing Rules of Racing for all members of Australian Junior, Under-23 and Senior Teams, both classic and beach sprint disciplines.  The frequency of screening shall follow the recommendations of the Australasian College of Sport and Exercise Physicians and the World Rowing requirements:

• Bi-annually from age 16 – 25 
• Every five years after the age of 25.

In the normal course of events this health screening will be conducted as follows:

 a. Education should be provided to athletes prior to the health screening regarding the process and its implications  b. The Team (or NIN) Doctor should perform the history taking and physical examination                                                 c. A Sport and Exercise Physician or Sports Cardiologist trained specifically in athlete ECG interpretation should           report the ECG                                                                                                                                                                                     d. Should follow up be required, the athlete will be referred to a Sports Cardiologist

For all other international events, such as the World Rowing Indoor Championships, World Rowing Coastal Championships, the World Rowing Tour, and the World Rowing Masters Regattas, it is strongly recommended that rowers participating in these events undergo this Pre-competition Health Screening, including at a minimum, discussion of cardiac risk factors, physical examination, and ECG with their own Medical Practitioner. Further cardiac investigations may be recommended prior to participation.