Christian Eriksen makes extraordinary return after cardiac arrest, but he′s not the first | Sports | German football and major international sports news | DW | 24.02.2022

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Christian Eriksen makes extraordinary return after cardiac arrest, but he's not the first

Christian Eriksen made his return to elite-level football on Saturday, just eight months after his cardiac arrest at Euro 2020. He played with an implanted defibrillator, as Daniel Engelbrecht did for five years.

Christian Eriksen making his debut for Brentford

Christian Eriksen's comeback ended in defeat on the pitch but is remarkable from a medical perspective

"I was watching the game with friends at a restaurant in Düsseldorf. When Christian Eriksen collapsed, my body froze. Every second he lay there without any heartbeat my fear increased. I knew the longer he was down, the more dangerous it became."

Daniel Engelbrecht knows exactly what Eriksen, who fell to the turf during a Euro 2020 match last year, was going through. In July 2013, he collapsed and entered cardiac arrest while playing for Stuttgarter Kickers in Germany's 3. Liga. He was down for 20-30 seconds before being awoken by a teammate.

"In the last years I’ve tried to forget what happened to me," Engelbrecht told DW. "But this situation with Christian Eriksen brought back to life my experience on 20 July 2013.

"For me, this was the most serious and emotional day of my life. Two days earlier I’d signed a new three-year contract with Stuttgarter Kickers and the doctor had told me that I was in great physical condition. I never thought that there might be something wrong with my heart.

Daniel Engelbrecht celebrates scoring the winning goal for Stuttgarter Kickers his first game back with a t-shirt that reads 'Nothing is impossible'

'Nothing is impossible': Daniel Engelbrecht celebrates scoring the winning goal for Stuttgarter Kickers his first game back

"In the 17th minute I started to feel like something was wrong. I felt a little dizzy and my knees began to feel weak. I couldn’t hear the people around me, but I could see them. I blanked out for 20-30 seconds, something like that.

"The next thing I remember is my teammate slapping me in the face, saying "Daniel, wake up, what’s wrong?" as he tried to bring me back to consciousness."

Engelbrecht, an ICD pioneer

Engelbrecht returned to the game almost 18 months and four operations later with the same type of implantable cardioverter-defibrillator (ICD) that Eriksen was fitted with a couple of days after his collapse in Copenhagen in June 2021.

Doctors wouldn't give Engelbrecht the green light to play again until the undiagnosed cause of his cardiac arrest had been corrected. While his story is similar to Eriksen's, subsequent examinations revealed Engelbrecht was suffering from myocarditis (an inflamed heart muscle) and an abnormal heart rhythm, whereas doctors have found no such abnormalities with Eriksen's heart. When Engelbrecht eventually made his comeback, he made German football history.

"I was the first football player in Germany to play with an ICD," Engelbrecht said. "People have ICDs and play football casually but it’s different as a professional, you are training every day and there is pressure. The doctors told me that they were worried because they have no experience of this, but my love for football was greater than my fear of dying."

Daniel Engelbrecht chests the ball while playing for TSV Steinbach

Engelbrecht in action for TSV Steinbach, one of four German clubs he played for while fitted with an ICD.

Engelbrecht played with his ICD for five years and the device has now given Eriksen hope of fulfilling his dream of playing for Denmark again and competing at the World Cup later this year.

"My dream is to rejoin the national team and play at Parken (Denmark's home stadium in Copenhagen) again and prove that it was a one-timer and that it won't happen again." Eriksen said. "I want to prove I've moved on. My goal is then to play at the World Cup in Qatar. I want to play, and that's been my mindset all along."

830 volts of electricity

Around three million people in the world have ICDs or a form of pacemaker, but very few of them play elite level sports afterwards. In Eriksen's case, his lack of an underlying heart problem makes him a good candidate to continue playing with an ICD.

"Without an underlying condition and with an ICD, there’s no reason why Eriksen cannot return to his old strength," Dr. Tim Niedergassel, team doctor at Bundesliga club Arminia Bielefeld, told DW. "There are a very select group of players that have played or are currently playing football with an ICD and we know that there have been basically no adverse reactions."

Running on a battery that lasts up to eight years, an ICD is capable of sending sizeable electric shocks to restore a regular heart rhythm, when necessary. It was necessary for Engelbrecht.

Surrounded by his teammates, Christian Eriksen lifts the Scudetto Trophy with Inter Milan last season.

Champion: Eriksen lifts the Scudetto Trophy with Inter Milan last season.

"My ICD gave me the inspiration to play. The only time I was scared was on January 28, 2014, when my ICD shocked me to make my heart beat again. It was then that I realized that I would be dead if the ICD didn’t rescue me. 830 volts of electricity being pumped through your body is not a nice feeling!"

'Nothing is impossible'

Englebrecht's return to the field on December 6, 2014, couldn't have been more emotional or memorable for the then 24-year-old.

"My club, Stuttgarter Kickers, were pushing for promotion and needed to win to go into second place. The score was 1-1 and I came off the bench in the 86th minute. In the 92nd minute, I scored the winner. It was unbelievable. Under my shirt, I had a message 'Nothing is impossible'. I was on all the talk shows in Germany, it was something extraordinary. I wish the same for Christian Eriksen!"

The Cologne-born Engelbrecht left Stuttgart in 2016 and went on to play for Alemannia Aachen, TSV Steinbach and Rot-Weiss Essen before retiring at 28 to go into coaching, scouting and player management. While he's grateful to have stayed in the game, he admits he was never the same after his comeback.

"I have to be honest with myself and I never got back to 100% after my heart problems," Engelbrecht explains. "I was able to reach 60-70% of my previous levels. I don’t know the exact issue Christian Eriksen has with his heart, but from my experience I know that it’s very difficult to come back to 100%. I really hope Christian can do it!"

Denmark's players encircle their teammate Christian Eriksen in a now iconic image.

Haunting: Denmark's players encircle their teammate Christian Eriksen in a now iconic image.

Eriksen was 'far away'

A lifeless Eriksen on the turf receiving life-saving CPR behind his Denmark teammates, who had formed a privacy ring as they locked arms around their stricken teammate, remains the defining image of Euro 2020.

With no warning sign and no history of cardiovascular problems, Eriksen's heart just stopped beating — for more than three minutes. 

Eriksen doesn't remember any of it. He blacked out just after receiving his teammate's throw-in — the next thing he remembers is doctors leaning over him and the distant sound of talking.

"Usually you remember bits of a dream, but I don't remember a thing from when I passed out," Eriksen told Danish broadcaster DR1 last month, in his first interview since his collapse. "I struggled to breathe as I came around but slowly I saw the doctors surrounding me and heard voices.

"When our cardiologist said that I'm 30, I corrected him and said "hey, I'm only 29". Then I regained consciousness right away."

London calling

Seven months on from June 12 and with the blessing of his fiancee and family, Eriksen made an astonishing return to Premier League football from the substitutes bench with Brentford on Saturday.

It came back in London, where Eriksen spent six-and-a-half years with Tottenham Hotspur. The Bees lost 0-2 to Newcastle but Eriksen's return was a bright spot after he came on shortly after the break.

With seven Danes in their squad and a Danish coach, Brentford should feel like home for the former Ajax player. Eriksen picked up two assists in a friendly game against Rangers on Monday and said after the game that he's in a good place mentally and physically, and is surprised at how well his body is holding up.

Increased risk while exercizing

While athletes are almost always young, fit and healthy, they are actually at a greater risk of a sudden cardiac arrest than non-athletes due to the law of averages — it's more likely to occur during periods of intense activity.

"The risk of sudden arrhythmic death syndrome is approximately 2.5 times higher during periods of intense physical activity," Dr. Niedergassel added.

"You have a higher risk of electrolyte disruption and the loss of potassium and sodium while sweating can affect the heart’s usual state. An underlying condition or stress can also trigger the loss of electrolytes.

"But as soon as the brain is starved of oxygen, it can only survive for around three to five minutes."

Eriksen's three minutes in the black placed him dangerously close to that threshold, making his comeback all the more astonishing. And when Eriksen makes his debut, Engelbrecht will be watching.

"I will watch Eriksen’s first game, for sure."

Edited by Matt Pearson