Key result
Cardiac screening with a 12-lead ECG improves sensitivity for detecting underlying cardiac disorders in athletes compared to history and physical examination alone.
Why the study?
Does preparticipation cardiac screening including a resting 12-lead ECG improve detection of underlying pathological cardiac disorders in athletes compared to history and physical examination alone?
Does preparticipation cardiac screening including a resting 12-lead ECG improve detection of underlying pathological cardiac disorders in athletes compared to history and physical examination alone?
Establishing standardized best practices for athlete cardiac screening, rather than debating mandatory programs, is essential to effectively identify athletes at risk for sudden cardiac arrest.
Cardiac screening of athletes has been passionately discussed for over two decades. Increased attention and controversy emerged after the publication of the 2005 European Society of Cardiology (ESC) guidelines endorsing a screening protocol inclusive of a resting 12-lead ECG.1 The American Heart Association (AHA) also strongly advocates for cardiovascular screening in athletes, but recommends a programme based only on a personal and family history and physical examination.2 After years of fervent debate, it is time to put passion aside and instead focus on the expanding body of knowledge which now exists. With careful analysis and thoughtful perspective, the discussion on cardiac screening can move forward—beyond the usual rhetoric—to benefit athletes and prevent sudden death. In this issue professors Levine and Thompson (USA) and professors Whyte and Wilson (Great Britain) debate ‘Challenges in Sports Cardiology: US versus European Approaches’ ( see page i9 ). The paper addresses several difficult questions on cardiac screening of athletes which are posed to both ‘sides’. While the expertise of the professionals involved in this debate is unquestionable, we add these comments for readers to consider regarding our current challenges to cardiac screening. If we could remove ‘mandatory’ from the discussion both sides might be a lot closer to agreeing on a screening protocol. We should consider that the focus on ‘mandatory’ or ‘national’ screening programmes has distracted this discussion from addressing key issues that affect the sports physician when faced with conducting a preparticipation evaluation. The merits of ECG screening are often examined and debated regarding the initiation of a nationalised, mandatory screening programme as existing in Italy.3 However, the questions that a sports physician (or consultant cardiologist) considers when seeing an athlete for a preparticipation evaluation may be very different. Sports physicians may ask: How should I be screening this athlete? What is …
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Börjesson et al. (2012) conducted an editorial in Athletes undergoing cardiovascular screening. Preparticipation cardiovascular screening with ECG vs. Screening based only on history and physical examination was evaluated. Cardiac screening with a 12-lead ECG improves sensitivity for detecting underlying cardiac disorders in athletes compared to history and physical examination alone.
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