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May 26, 2021Journal of Athletic TrainingOpen Access

ECG screening in young athletes and military members showed an inconclusive effect on sudden cardiac death risk (RR 0.58; 95% CI 0.23-1.45), based on very low-quality evidence with high bias.

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Why the study?

To determine the effect of ECG screening on the prevention of sudden cardiac arrest and death in young athletes and military members.

Does preparticipation examination including ECG screening prevent sudden cardiac arrest and death in young athletes and military members aged ≤40 years?

Population

11 689 172 athletes or military members aged ≤40 years across 4 nonrandomized studies

Comparison

Preparticipation examination including ECG vs no screening, usual care, or preparticipation examination without ECG

Design

Systematic review and meta-analysis of nonrandomized studies

Key result

ECG screening in young athletes and military members showed an inconclusive effect on sudden cardiac death risk (RR 0.58; 95% CI 0.23-1.45), based on very low-quality evidence with high bias.

Authors

ALAaron LearNPNiraj PatelCMChanda Mullen

Discussion

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Member takes

Overview

ECG screening benefits remain uncertain in young athletes; leaves open the value of routine use pending higher-quality trials.

Study Design

Type

Meta-Analysis (n=11,689,172)

Structured PICO

Does preparticipation examination including ECG screening prevent sudden cardiac arrest and death in young athletes and military members aged ≤40 years?

P
Population
11,689,172 young athletes and military members aged ≤40 years from 4 nonrandomized studies evaluating ECG screening.
I
Intervention
Preparticipation examination including electrocardiogram (ECG) screening
C
Comparator
No screening, usual care, or preparticipation examination without ECG
O
Outcome
Prevention of sudden cardiac arrest and deathhard clinical

Main Result

Relative Risk: 0.58 (95% CI 0.23–1.45)

Absolute Risk Reduction: 0.0016%

Existing evidence for the effect of ECG screening on preventing sudden cardiac death in young athletes and military members is of very low quality and inconclusive.

Limitations

  • High risk of bias in all included studies
  • High heterogeneity (I2 = 71%)
  • Very low-quality evidence
  • High heterogeneity (I²=71%)
  • Only 4 studies identified, none randomized

Cite This Study

Lear et al. (2021) conducted a meta-analysis in Sudden cardiac arrest and death (n=11,689,172). Electrocardiogram (ECG) screening vs. No screening, usual care, or preparticipation examination without ECG was evaluated on Sudden cardiac death (RR 0.58, 95% CI 0.23, 1.45). ECG screening in young athletes and military members showed an inconclusive effect on sudden cardiac death risk (RR 0.58; 95% CI 0.23-1.45), based on very low-quality evidence with high bias.

synapsesocial.com/papers/6a52fbb405ef92d1f13d8ed6https://doi.org/10.4085/1062-6050-0746.20
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Screening electrocardiogram in young athletes and military members: a systematic review and meta-analysis2020 · 2 citations
  2. 2Meta-analysis on the Effectiveness of ECG Screening for Conditions Related to Sudden Cardiac Death in Young Athletes2023 · 15 citations
  3. 3The Evidence Against Cardiac Screening Using Electrocardiogram in Athletes2016 · 13 citations
  4. 4Cardiovascular Screening in Young Athletes2016 · 21 citations
  5. 5Screening for prevention of sudden death in the young2019 · 3 citations