I am not an M.D.but I did research and write quite a lot about this issue in my Fearless Swimming book a few years ago.......
What is groundbreaking here is that the RD is sending multiple warnings/information/training opportunities to the athletes AND is also having the health screenings.
If you don't get an AED on a cardiac arrest within 2 minutes, the person is unlikely to survive plus the AED won't work on a wet victim laying in puddle of water so you can see how futile the rescue issues are. Prevention is the key and odds are that people are still going to die. I think that triathletes need to realize that they are not invincible. Indeed, endurance athletes may very well be at greater risk for certain heart abnormalities than others.
The best information I have seen on the subject is that the vast majority of deaths have been due to pre-existing heart conditions that were either known or undiagnosed. So the take home is that you need a full cardiac workup to make sure you know what your issues are. That said, a cardio workup can be wrong and of course other medical issues can cause death so having the workup is not a guarantee, it is just a relatively simple first step. I think coaches should be pressing their clients to get this screening as well.
An EKG is standard and it is usually covered by insurance. But and EKG will not necessarily reveal structural abnormalities that can cause sudden cardiac death like we hear about when high school kids drop dead at a football practice. So you need and Echogardiogram and those cost extra. I think even $400 is silly to quibble over as far as cost when your life is at stake. If your doc won't order the Echo you should check out Empfield's article
on this site and take advantage of the screenings offered there....or find a SportsMed doc.
As for what is causing the deaths, no one really knows because no one has REALLY investigated causes.The USAT study was (in my opinion) pathetic merely did a bunch number crunching to determine if the number of deaths are unusual given the number of participants. They concluded that the numbers were within norms and looked at correlations, finding a long list of things that do not seem
to be related to the deaths (experience, swimming ability, race distance, mass start,SIPE, panic,etc. ---won't rehash them all here.. USAT as the governing body,was obviously concerned more with the liability issues and this study served the purpose of getting them off the hook.
Good info on this is available on Dr. Lawrence Creswell's blog, The Athlete's Heart
I hope a university will take on this issue and spend a few years really studying the matter. It won't be easy but nothing worthwhile ever is.
Ironman Series Books: "Ironplanner" "Weight Management For Triathletes""Fearless Swimming For Triathletes""Functional Strength For Triathletes"