Key result
Nationwide adolescent cardiac screening proves feasible, identifying SCD-linked conditions in ~0.3% of participants.
Why the study?
The feasibility and diagnostic yield of a nationwide cardiac screening programme to identify disorders linked to sudden cardiac death in adolescents had never been explored.
Does a nationwide systematic cardiac screening programme improve the identification of conditions linked to sudden cardiac death in adolescents?
Cross-Sectional (n=2,708)
Does a nationwide systematic cardiac screening programme improve the identification of conditions linked to sudden cardiac death in adolescents?
A nationwide systematic cardiac screening programme for adolescents using a questionnaire and ECG is feasible, cost-efficient, and identifies conditions linked to sudden cardiac death in 0.3% of individuals.
Supports adolescent cardiac screening feasibility; hypothesis-generating for sudden cardiac death prevention, pending prospective trials.
AIMS: Sudden cardiac death (SCD) in young individuals is often unexpected, provoking substantial emotional stress for family and friends of the deceased. Cardiac screening may identify individuals who harbour disorders linked to SCD. The feasibility and diagnostic yield of a nationwide cardiac screening programme in adolescents has never been explored. METHODS: All individuals eligible for cardiac screening (students aged 15 years) were systematically invited to enrol. Students were provided with a health questionnaire. ECGs were acquired at school. A physician led consultation was carried out on site. Participants with an abnormal screen were then referred for secondary evaluation to the nation's tertiary centre. Feasibility criteria included a) participation rate >60%, b) adherence to secondary evaluation >80%, and c) cost per individual screened equating to <€100. The diagnostic yield was also evaluated. RESULTS: At the end of enrolment, 2708 students gave consent (mean 15 years, 50.4% male), equating to 67.9% of the eligible cohort. Overall, 109 participants (4.0%) were referred for further evaluation. An abnormal electrocardiogram (ECG) was the most common reason for referral (3.7%). Fifteen individuals (0.6%) were diagnosed with a cardiac condition. Nine (0.3%) had a condition linked to SCD (n = 1 Long-QT syndrome, n = 1 Hypertrophic Cardiomyopathy, n = 5 Wolff-Parkinson White, n = 2 coronary anomalies). The yield was similar in athletes and non-athletes (p = 0.324). The cost per cardiac individual screened equated to €51.15. CONCLUSION: A nationwide systematic cardiac screening programme for adolescent athletes and non-athletes is feasible and cost-efficient, provided that responsible centres have the appropriate infrastructure.
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Abela et al. (2023) conducted a cross-sectional in Adolescents eligible for cardiac screening (n=2,708). Nationwide systematic cardiac screening (health questionnaire and ECG) was evaluated on Diagnostic yield of cardiac conditions. A nationwide systematic cardiac screening program in adolescents was feasible and cost-efficient at €51.15 per individual, identifying cardiac conditions linked to sudden cardiac death in 0.3% of participants.
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