This editorial refers to ‘Major regional disparities in outcomes after sudden cardiac arrest during sports’, by E. Marijon et al. doi:10.1093/eurheartj/eht282 and ‘Exercise-related out-of-hospital cardiac arrest in the general population: incidence and prognosis’, by J. Berdowski et al. doi:10.1093/eurheartj/eht401 Exercise can trigger an acute cardiac event which may precipitate sudden cardiac arrest (SCA).1 On the other hand, exercise is important for physical fitness and prevention of cardiovascular disease,1 and the medical community should therefore inform the general public of the health benefits of sports and exercise.2 At the same time, the public are exposed to alarmist mass media coverage of athletes or ordinary people collapsing during different sport activities, raising uncertainties, questions, and debate within communities. The worst possible consequence would be that the public abstain from physical exercise. It is therefore of utmost importance to document the current reality of sports-related SCA. In two studies from France and The Netherlands, the incidence and prognosis of exercise-related out-of-hospital cardiac arrest (OHCA) have now been reported.3,4 Different epidemiological characteristics and factors associated with improved survival were explored, analysed, and investigated. In a 5-year community-based French registry assessing the incidence and outcome of SCA during sports in subjects of 10–75 years old, Marijon and co-workers recorded 820 SCAs, with a mean age of 46 years and a 20:1 predominance of male victims. Half of the SCAs occurred in typical sports facilities. Their major finding was huge regional disparities related to survival. The overall survival at hospital discharge was 16%, varying from 3% in the worst regions up to 44% in the best regions. As in OHCA in general, bystander cardiopulmonary resuscitation (CPR) was a main contributor to the survival differences, …