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When chaos can kill

What causes sudden cardiac arrest?

Young athletes seem to be dropping like the rain. Happily, Bolton Wanderers’ Fabrice Muamba is making a full recovery after his heart stopped during a match in March. The Italian footballer Piermario Morosini was not so lucky; he died on the pitch in Pescara last month. We don’t yet know for sure what killed him – nor the London Marathon runner Claire Squires. But it seems likely that the foibles of the human heart are to blame – in the UK alone, 12 people under the age of 35 succumb to “sudden cardiac death” every week.

The heart beats because of co-ordinated pulses of electricity that work their way through its cells in a wave, causing muscle to contract in a tightly synchronised dance that creates a highly efficient pumping mechanism. Under stress, this rhythm can break down. The organ falls into what physicists know as chaos.

In general, chaos has a strange beauty. Watching a chaotic pendulum swing is entrancing. Some of the movements look so tiny that you think the pendulum must be about to stop – and then it doesn’t. A chaotic system never repeats its movements, giving it unpredictable qualities. That is why a butterfly flapping its wings in Brazil really can cause a tornado in Texas.

A chaotic arrhythmia in the heart is equally disastrous. When the heart’s muscles contract in never-repeating patterns, the organ becomes a seething, pulsating mess of tissue rather than a pump. The defibrillators that stop this do not give a random jolt of electricity: the pulse is carefully designed to take the chaos into account and provide the electrical current patterns and pulses that will halt the quivering. Only then can the heart re-establish its proper beat.

As marvellous an invention as the defibrillator is, it would be much better to identify those whose hearts are prone to slipping into chaos. This has proved a surprisingly contentious task.

Two recent reviews of the scientific literature published in the same journal (Progress in Cardiovascular Disease) came to almost opposite conclusions. One suggests that an electrocardiogram is the only effective means of detecting a latent problem. The other says ECGs “have not been demonstrated to be effective in decreasing the inherent risk of athletic sudden death”.

Warning signs

A consensus is growing, however, that ECG screening does help. Fifa and Uefa both require that all professional footballers undergo ECG tests but Muamba’s case has provoked questions about whether the tests are being done often enough – or well enough. The FA’s medical committee will meet on 3 May to dissect the incident, and Premier League team doctors are getting together a week later to examine Muamba’s medical records to see whether any warning signs were missed.

For all the concern over professionals, it is amateur athletes who drop dead far too frequently. It is difficult to deal with the problem because many of these deaths are recorded as unexplained; post-mortem, many intricacies and weaknesses of a heart are undetectable. What is known is that one in 300 people has some kind of heart defect.

Those doing sport are at nearly three times greater risk of sudden cardiac death, which is why the European Society of Cardiology and the International Olympic Committee have recommended that any young person taking part in competitive sport should undergo precautionary screening. However, generally there is very limited access to such facilities. The charity Cardiac Risk in the Young has enlisted a few famous faces (David Walliams, Pixie Lott and James Cracknell) to help change that. But cardiac chaos will claim many more lives in the foreseeable future. 

For a list of ECG screening clinics for young people, visit

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 07 May 2012 issue of the New Statesman, The Science Issue

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Labour tensions boil over at fractious MPs' meeting

Corbyn supporters and critics clash over fiscal charter U-turn and new group Momentum. 

"A total fucking shambles". That was the verdict of the usually emollient Ben Bradshaw as he left tonight's Parliamentary Labour Party meeting. His words were echoed by MPs from all wings of the party. "I've never seen anything like it," one shadow minister told me. In commitee room 14 of the House of Commons, tensions within the party - over the U-turn on George Osborne's fiscal charter and new Corbynite group Momentum - erupted. 

After a short speech by Jeremy Corbyn, shadow chancellor John McDonnell sought to explain his decision to oppose Osborne's fiscal charter (having supported it just two weeks ago). He cited the change in global economic conditions and the refusal to allow Labour to table an amendment. McDonnell also vowed to assist colleagues in Scotland in challenging the SNP anti-austerity claims. But MPs were left unimpressed. "I don't think I've ever heard a weaker round of applause at the PLP than the one John McDonnell just got," one told me. MPs believe that McDonnell's U-turn was due to his failure to realise that the fiscal charter mandated an absolute budget surplus (leaving no room to borrow to invest), rather than merely a current budget surplus. "A huge joke" was how a furious John Mann described it. He and others were outraged by the lack of consultation over the move. "At 1:45pm he [McDonnell] said he was considering our position and would consult with the PLP and the shadow cabinet," one MP told me. "Then he announces it before 6pm PLP and tomorow's shadow cabinet." 

When former shadow cabinet minister Mary Creagh asked Corbyn about the new group Momentum, which some fear could be used as a vehicle to deselect critical MPs (receiving what was described as a weak response), Richard Burgon, one of the body's directors, offered a lengthy defence and was, one MP said, "just humiliated". He added: "It looked at one point like they weren't even going to let him finish. As the fractious exchanges were overheard by journalists outside, Emily Thornberry appealed to colleagues to stop texting hacks and keep their voices down (within earshot of all). 

After a calmer conference than most expected, tonight's meeting was evidence of how great the tensions within Labour remain. Veteran MPs described it as the worst PLP gathering for 30 years. The fear for all MPs is that they have the potential to get even worse. 

George Eaton is political editor of the New Statesman.