Key result
Screening ECGs identify disqualifying cardiac abnormalities in ~0.6% of cadets missed by standard exams.
Why the study?
The low sensitivity of traditional history and physical exam in detecting underlying cardiac abnormalities in young healthy individuals has led to debate about routine ECG screening.
Does routine screening ECG improve the detection of silent cardiac abnormalities compared to history and physical exam in ROTC cadets applying for flight status?
Cross-Sectional (n=1,099)
Does routine screening ECG improve the detection of silent cardiac abnormalities compared to history and physical exam in ROTC cadets applying for flight status?
Routine screening ECGs identified silent, potentially arrhythmogenic cardiac abnormalities in 0.6% of healthy young ROTC cadets that were missed by standard history and physical exams.
Answers are grounded in this paper and cite their sources.
May support targeted ECG screening in select young adults; leaves open outcome impact without prospective trials.
The majority of sudden, nontraumatic deaths in young, otherwise healthy individuals result from an unknown underlying cardiac abnormality. The low sensitivity of the traditional history and physical exam in detecting these anomalies has led to a debate regarding the use of routine screening electrocardiograms (ECGs) in young adults. The present study screened 1,099 ROTC cadets applying for aviator status during the summers of 2005 and 2006. Seven candidates (0.6%) were disqualified because of ECG abnormalities, including two with Wolf Parkinson White syndrome. None of the individuals were identified by history and physical exam. ECG was an effective screening tool for detecting silent abnormalities with potential for arrhythmia in our population of healthy young adults. Other ECG findings indicative of anatomic abnormalities were not found. ECG screening can be a valuable tool and should be used in evaluating certain subsets of the population.
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Liesemer et al. (2010) conducted a cross-sectional in Healthy young adults (n=1,099). Screening electrocardiograms (ECGs) vs. History and physical exam was evaluated on Disqualification because of ECG abnormalities. Screening electrocardiograms in 1,099 ROTC cadets identified 7 with disqualifying cardiac abnormalities that were missed by traditional history and physical examination.
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