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The author argues that resting ECG screening for asymptomatic athletes is standard of care and cost-effective, contrary to the ACP guideline recommendation against screening asymptomatic adults.
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This letter challenges the ACP guideline recommendation against routine resting ECG screening in asymptomatic adults, highlighting its role in athlete preparticipation screening.
Letters21 July 2015Cardiac ScreeningPaul Zimmermann, MDPaul Zimmermann, MDFrom South Carolina Heart Center, Camden, South Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5112 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Chou's guideline (1) on cardiac screening recommends that asymptomatic adults not have resting electrocardiography (ECG). I find that this recommendation, in many instances, goes against the standard of care. Obtaining ECGs for screening is standard for athletes, who, by definition, are asymptomatic. The European Community (2) continues to find this intervention cost-effective.To argue against screening ECGs, Chou cites 2 articles showing their limited usefulness. Rubenstein and Greenfield (3) found that "the routine ECG has little value as a baseline." However, they state that 5% of patients were grouped into a class in which ECGs could be ...References1. Chou R; High Value Care Task Force of the American College of Physicians. Cardiac screening with electrocardiography, stress echocardiography, or myocardial perfusion imaging: advice for high-value care from the American College of Physicians. Ann Intern Med. 2015;162:438-47. [PMID: 25775317] doi:10.7326/M14-1225 LinkGoogle Scholar2. Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation. 2007;116:2616-26. [PMID: 18040041] CrossrefMedlineGoogle Scholar3. Rubenstein LZ, Greenfield S. The baseline ECG in the evaluation of acute cardiac complaints. JAMA. 1980;244:2536-9. [PMID: 7431589] CrossrefMedlineGoogle Scholar4. Hoffman JR, Igarashi E. Influence of electrocardiographic findings on admission decisions in patients with acute chest pain. Am J Med. 1985;79:699-707. [PMID: 4073107] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul Zimmermann, MDAffiliations: From South Carolina Heart Center, Camden, South Carolina.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=L15-0260. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCardiac Screening With Electrocardiography, Stress Echocardiography, or Myocardial Perfusion Imaging: Advice for High-Value Care From the American College of Physicians Roger Chou and Cardiac Screening With Electrocardiography, Stress Echocardiography, or Myocardial Perfusion Imaging: Advice for High-Value Care From the American College of Physicians Roger Chou and Cardiac Screening Roger Chou Cardiac Screening Roger Chou Metrics 21 July 2015Volume 163, Issue 2Page: 151KeywordsConflicts of interestDisclosureElectrocardiographyIschemia ePublished: 21 July 2015 Issue Published: 21 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Paul Zimmermann (2015) conducted a letter in Asymptomatic adults and athletes. Resting electrocardiography (ECG) screening vs. No screening was evaluated. The author argues that resting ECG screening for asymptomatic athletes is standard of care and cost-effective, contrary to the ACP guideline recommendation against screening asymptomatic adults.
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