Key result
ECG screening in older adults detects major abnormalities in ~3% of individuals.
Why the study?
The clinical relevance and prevalence of major ECG abnormalities in a population-based cardiovascular screening context of 67-year-old Danes were not well described.
Does a single resting 12-lead ECG screening detect major ECG abnormalities requiring intervention in 67-year-old adults?
Cohort (n=4,437)
Does a single resting 12-lead ECG screening detect major ECG abnormalities requiring intervention in 67-year-old adults?
Population-based screening with a single 12-lead ECG in 67-year-olds has a low overall yield but can identify a small proportion of individuals with major ECG abnormalities requiring clinical intervention.
Answers are grounded in this paper and cite their sources.
Low yield from ECG screening in 67-year-olds warrants caution against routine use; leaves open outcome benefits in unselected older adults.
OBJECTIVES: To describe the point prevalence of major ECG abnormalities, their coexistence with screen-detected cardiovascular disease (CVD) and the proportion requiring referral for cardiac work-up and interventions. DESIGN: A population-based cohort study. SETTING: Primary and secondary care settings in Denmark. PARTICIPANTS: Since 2014, all 67-year-old Danish men and women from Viborg municipality were invited to the 'Viborg Screening Programme' (VISP). INTERVENTIONS: VISP includes screening for lower extremity artery disease (LEAD), carotid plaque (CP), abdominal aortic aneurysm (AAA), hypertension, diabetes mellitus and cardiac conditions. PRIMARY OUTCOME MEASURES: A single resting 12-lead ECG was recorded and coded using the Minnesota criteria. Major ECG abnormalities were divided into rhythm and rate disorders, signs of myocardial damage and conduction disorders. RESULTS: Over the first 5 years, 4612 (83.8% of those invited) were screened, with 4437 (96.4%) undergoing an ECG. We found major ECG abnormalities in 152 (3.4%), including 92 (2.1%) rhythm and rate disorders, 28 (0.6%) with signs of myocardial damage and 32 (0.7%) with conduction disorders. Fifty-nine (1.3%) had newly screen-detected ECG abnormalities, and 34 (0.8%) required intervention after cardiac consultation (32 medication adjustments and/or 11 advanced treatments). Participants with major ECG abnormalities had a higher frequency of coexisting CVD, including CP (46.4% vs 38.1%; p=0.040), LEAD (9.5% vs 5.3%; p=0.026) and AAA (2.7% vs 0.9%; p=0.032) and were also more common in men than in women (4.7% vs 2.2%; p<0.001). Adjusted OR showed significantly higher risk for screen-detected major ECG abnormalities in current smokers (aOR 2.07, 95% CI 1.05 to 4.09), but a lower risk in participants using lipid-lowering medication (aOR 0.39, 95% CI 0.19 to 0.80). CONCLUSION: This study provides a detailed overview of major ECG abnormalities in a population-based cardiovascular screening context. Although the yield of ECG screening was low, ECG may still add value as a simple and low-cost tool within multimodal programmes, enabling timely detection and treatment. TRIAL REGISTRATION NUMBER: NCT03395509.
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Giessen et al. (2025) conducted a cohort in Cardiovascular disease screening (n=4,437). Cardiovascular screening program including 12-lead ECG was evaluated on Point prevalence of major ECG abnormalities. Screening 67-year-old adults with a 12-lead ECG revealed a 3.4% point prevalence of major ECG abnormalities, leading to newly detected abnormalities in 1.3% and clinical interventions in 0.8%.
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