Key result
Adding an ECG to history and physical examination screening is more sensitive than history and physical examination alone in identifying youth at risk for sudden cardiac death.
Why the study?
Does adding an ECG to history and physical examination improve the identification of youth at risk for sudden cardiac death?
Does adding an ECG to history and physical examination improve the identification of youth at risk for sudden cardiac death?
Adding an ECG to standard history and physical examination increases sensitivity for identifying youth at risk for sudden cardiac death, though management of identified patients requires further study.
May support targeted ECG screening for SCD prevention; leaves open broader adoption pending randomized cost-effectiveness trials.
PURPOSE OF REVIEW: Frequent media reports of sudden cardiac arrest or death (SCA/SCD) keep alive a debate as to how best to prevent these tragedies. Several new studies in the past 2 years serve as an impetus to reframe the debate into a reasonable discussion that seeks to obtain more evidence wherever needed and to develop a consensus wherever possible. RECENT FINDINGS: Since the report from Italy of the 89% decrease in SCD over 25 years of an ECG-based cardiovascular screening program, proponents and opponents of ECG screening have been busily debating. Multiple studies on screening have shown that adding an ECG to a history and physical examination is more sensitive than history and physical examination alone in identifying those potentially at risk. A major gap exists regarding managing these new 'patients' as their clinical course is not known. Reports, without data, have warned of unintended or harmful consequences of ECG screening. Economic models have shown cost-effectiveness of ECG screening to be variable. SUMMARY: Studies suggest that adding an ECG to the screening is a very reasonable effort that will identify at-risk youth and prevent SCD, but more information is needed. If data support the addition of an ECG, efforts should be made to make this opportunity available.
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Vetter et al. (2013) conducted a review in Sudden cardiac arrest or death (SCA/SCD). Electrocardiographic (ECG) screening vs. History and physical examination alone was evaluated on Sudden cardiac death. Adding an ECG to history and physical examination screening is more sensitive than history and physical examination alone in identifying youth at risk for sudden cardiac death.
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