Wednesday, January 14, 2009

ECG screening precompetition reduces sudden death in young athletes

Pre-participation Screening of Young Competitive Athletes for Prevention of Sudden Cardiac Death

Journal of the American College of Cardiology
Posted 01/07/2009
Domenico Corrado, MD, PhD; Cristina Basso, MD, PhD; Maurizio Schiavon, MD; Antonio Pelliccia, MD; Gaetano Thiene, MDAuthor Information

In 1982 a nationwide program of pre-participation screening including 12-lead electrocardiography (ECG) was launched in Italy. The aim of this article is to examine whether this 25-year screening program should be considered a valid and advisable public health
The analysis of data coming from the long-running Italian experience indicates that ECG screening has provided adequate sensitivity and specificity for detection of potentially lethal cardiomyopathy or arrhythmias and has led to substantial reduction of mortality of young competitive athletes by approximately 90%.

Screening was feasible thanks to the Italian Health System, which is developed in terms of health care and prevention services, and because of the limited costs of cardiovascular evaluation in the setting of a mass program.

On the basis of current scientific evidence the implementation of a mass-screening program aimed to prevent athletic-field sudden cardiac death should be at least carefully considered by public health administrators worldwide.

"He who saves a single life saves the whole world." --Talmud Sanhedrin 4:5[1]
Sudden death during sports is often the first and definitive manifestation of an underlying cardiovascular disease, which usually has a silent clinical course.[2-6] Medical evaluation before competition offers the potential to detect still asymptomatic athletes with life-threatening heart diseases and to protect them from sudden cardiac death (SCD).