When Christian Eriksen collapsed during Denmark’s 2-1 friendly victory over Ukraine, his implantable cardioverter defibrillator activated to support his heart as medical staff attended to him.
The ICD, which is roughly half the size of a mobile phone, sits inside Eriksen’s chest with wires connecting directly to his heart to monitor and correct dangerous rhythms.
The device can deliver a shock to either restart the heart if it stops beating entirely, or to restore a regular rhythm when abnormalities are detected.
Denmark’s national team doctor Morten Boesen confirmed after Sunday’s incident that “the pacemaker responded as it should,” offering some reassurance to those watching on.
Eriksen previously suffered a cardiac arrest during a Euro 2020 match, making Sunday’s collapse a deeply unsettling moment for supporters and team-mates who witnessed it first-hand.
Dr Amanda Lahti, a doctor and researcher in sports medicine, explains that decisions around returning to elite competition are never straightforward and always involve multiple parties.
“It is a shared decision model – you take opinions from the club, the player, their agent, and medical experts, looking at the risks and the potential benefits,” said Dr Lahti.
“The difficulty with that is the athlete themselves has the final word, and they will never say ‘stop’. They are willing to take risks that perhaps you or I would not.”
Eriksen was unable to continue playing in Serie A after his 2021 cardiac arrest, as Italy’s league prohibits ICD-fitted players from competing, but he returned to football with Brentford and then Manchester United in the Premier League.
Most recently, he spent the past season at Wolfsburg in the Bundesliga, which like the Premier League, Fifa, and Uefa, permits players with ICDs to participate in competition following individual health assessments.
Dr Lahti notes that medical opinion on the subject has evolved considerably over recent decades, with a more nuanced approach replacing what was once a blanket prohibition on sport of any kind.
“Around the millennium, everyone was just told no – you don’t take part in any sport, not even recreational,” she said, adding that athletes who ignored that advice often demonstrated the devices performed better than expected.
“ICDs today are very good. They tolerate physical contact and most often they defibrillate fast. But it’s not 100% – there is no guarantee that you survive.”
Former England cricketer James Taylor, who retired aged 26 after being diagnosed with a genetic heart disease, describes the experience of an ICD activating as startling but ultimately life-saving.
“I had only had it a month before it kicked in – I was on stage, talking about the device ironically, and then it went off,” said Taylor.
“It is like a mini explosion in my chest. It blew me backwards about a metre or so. I was conscious the whole time but I can’t remember much after it went off.”
Taylor also experienced an inappropriate shock while on holiday in Antigua, where the device mistakenly detected what it believed was a heart rate of 500 beats per minute, triggered by a pool pump rather than a genuine cardiac event.
Despite those frightening episodes, Taylor says the ICD provides him with confidence and reassurance in daily life, though he acknowledges the psychological challenges that come with the condition.
Former footballer Clive Clarke, who suffered a cardiac arrest in the changing room while playing for Leicester City in 2007 and was fitted with an ICD aged 27, ultimately chose to walk away from the professional game despite believing he could still perform at a high level.
“I came to the decision that no, I wasn’t in the headspace to do that,” Clarke said, citing a young family and concerns about deaths on the pitch around that time as key factors in his choice.
Now on his third ICD, Clarke raises questions about whether players should be permitted to compete with the device, pointing to the potential psychological impact on team-mates and staff if something were to go wrong during a match.
