Is there evidence for recommending electrocardiogram as part of the pre-participation examination?

Clinical Journal of Sport Medicine

Volumn 21, Issue 1, 2011, Pages 18-24

  Drezner, Jonathan ^a   Corrado, Domenico ^b  

^a UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF PADUA MEDICAL SCHOOL   (Italy)

Author keywords

athlete; electrocardiogram; prevention; screening; sport; sudden cardiac death

Indexed keywords

ARTICLE; ATHLETE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CLINICAL EFFECTIVENESS; COST EFFECTIVENESS ANALYSIS; ELECTROCARDIOGRAM; EVIDENCE BASED PRACTICE; HUMAN; INCIDENCE; MEDICAL SOCIETY; PHYSICAL EXAMINATION; PREVALENCE; PRIMARY PREVENTION; PRIORITY JOURNAL; SUDDEN DEATH;

ADOLESCENT; ADULT; ATHLETES; CARDIOVASCULAR DISEASES; CHILD; DEATH, SUDDEN, CARDIAC; ELECTROCARDIOGRAPHY; EVIDENCE-BASED MEDICINE; FALSE POSITIVE REACTIONS; FEASIBILITY STUDIES; HUMANS; MASS SCREENING; MEDICAL HISTORY TAKING; PHYSICAL EXAMINATION; PRIMARY PREVENTION; RISK ASSESSMENT; SPORTS MEDICINE; YOUNG ADULT;

EID: 78651385046     PISSN: 1050642X     EISSN: None     Source Type: Journal    
DOI: 10.1097/JSM.0b013e318205dfb2     Document Type: Article

References (50)

1. Maron BJ, Doerer JJ, Haas TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009;119:1085-1092.
2. Maron BJ. Sudden death in young athletes. N Engl J Med. 2003;349: 1064-1075.
3. Asif I, Harmon K, Drezner J, et al. Incidence and etiology of sudden death in NCAA athletes. Clin J Sport Med. 2010;20:136.
4. Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 2007;115:1643-1455.
5. Corrado D, Pelliccia A, Bjornstad HH, et al. Cardiovascular preparticipation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26:516-524.
6. Ljungqvist A, Jenoure P, Engebretsen L, et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med. 2009;43:631-643.
7. Corrado D, Basso C, Pavei A, et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006;296:1593-1601. (Pubitemid 44515020)
8. Thompson PD, Levine BD. Protecting athletes from sudden cardiac death. JAMA. 2006;296:1648-1650.
9. Van Camp SP, Bloor CM, Mueller FO, et al. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995;27:641-647.
10. Maron BJ, Gohman TE, Aeppli D. Prevalence of sudden cardiac death during competitive sports activities in Minnesota high school athletes. J Am Coll Cardiol. 1998;32:1881-1884.
11. Eckart RE, Scoville SL, Campbell CL, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004;141:829-834.
12. Drezner JA, Rogers KJ, Zimmer RR, et al. Use of automated external defibrillators at NCAA Division I universities. Med Sci Sports Exerc. 2005;37:1487-1492.
13. Drezner JA, Rao AL, Heistand J, et al. Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation. 2009;120:518-525.
14. Atkins DL, Everson-Stewart S, Sears GK, et al. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation. 2009;119:1484-1491.
15. Chugh SS, Reinier K, Balaji S, et al. Population-based analysis of sudden death in children: the Oregon Sudden Unexpected Death Study. Heart Rhythm. 2009;6:1618-1622.
16. Corrado D, Basso C, Rizzoli G, et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42:1959-1963.
17. Heron M, Hoyert D, Murphy S, et al. Deaths: final data for 2006. Natl Vital Stat Rep. 2009;57:1-136.
18. Drezner J, Berger S, Campbell R. Current controversies in the cardiovascular screening of athletes. Curr Sports Med Rep. 2010;9:86-92.
19. Maron BJ, Zipes DP. 36th Bethesda Conference: eligibility recommendations for competitive athletes with cardiovascular abnormalities. J Am Coll Cardiol. 2005;45:1312-1377.
20. American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. PPE Preparticipation Physical Evaluation. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2010.
21. Fuller CM, McNulty CM, Spring DA, et al. Prospective screening of 5,615 high school athletes for risk of sudden cardiac death. Med Sci Sports Exerc. 1997;29:1131-1138.
22. Wilson MG, Basavarajaiah S, Whyte GP, et al. Efficacy of personal symptom and family history questionnaires when screening for inherited cardiac pathologies: the role of electrocardiography. Br J Sports Med. 2008;42:207-211.
23. Bessem B, Groot FP, Nieuwland W. The Lausanne recommendations: a Dutch experience. Br J Sports Med. 2009;43:708-715.
24. Hevia AC, Fernandez MM, Palacio JM, et al. ECG as a part of the preparticipation screening programme: an old and still present international dilemma [published online ahead of print July 15, 2010]. Br J Sports Med. doi 10.1136/bjsm.2009.063958.
25. Baggish AL, Hutter AM Jr, Wang F, et al. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med. 2010;152:269-275.
26. Maron BJ, Thompson PD, Puffer JC, et al. Cardiovascular preparticipation screening of competitive athletes. A statement for health professionals from the Sudden Death Committee (clinical cardiology) and Congenital Cardiac Defects Committee (cardiovascular disease in the young), American Heart Association. Circulation. 1996;94:850-856.
27. de Noronha SV, Sharma S, Papadakis M, et al. Aetiology of sudden cardiac death in athletes in the United Kingdom: a pathological study. Heart. 2009;95:1409-1414.
28. Maron BJ, Shirani J, Poliac LC, et al. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA. 1996; 276:199-204.
29. Basso C, Maron BJ, Corrado D, et al. Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol. 2000; 35:1493-1501.
30. Gomez JE, Lantry BR, Saathoff KN. Current use of adequate preparticipation history forms for heart disease screening of high school athletes. Arch Pediatr Adolesc Med. 1999;153:723-726.
31. Glover DW, Glover DW, Maron BJ. Evolution in the process of screening United States high school student-athletes for cardiovascular disease. Am J Cardiol. 2007;100:1709-1712.
32. Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation. 2007;116: 2610-2614.
33. Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation. 2007;116:2616-2626.
34. International Olympic Committee. International Olympic Committee Medical Commission. Sudden cardiovascular death in sport: Lausanne recommendations on preparticipation cardiovascular screening. 2004. http://multimedia. olympic.org/pdf/en-report-886.pdf. Accessed December 3, 2010.
35. Nora M, Zimmerman F, Ow P, et al. Preliminary findings of ECG screening in 9,125 young adults [abstract 3718]. Circulation. 2007; 116:845.
36. Maron BJ. Distinguishing hypertrophic cardiomyopathy from athlete's heart physiological remodelling: clinical significance, diagnostic strategies and implications for preparticipation screening. Br J Sports Med. 2009;43:649-656.
37. Maron BJ, Roberts WC, Epstein SE. Sudden death in hypertrophic cardiomyopathy: a profile of 78 patients. Circulation. 1982;65: 1388-1394.
38. Corrado D, Basso C, Fontaine G. Clinical profile of young competitive athletes who died suddenly of arrhythmogenic right ventricular cardiomyopathy/dysplasia: a multicenter study. Pacing Clin Electrophysiol. 2002;25:544.
39. Corrado D, Basso C, Schiavon M, et al. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med. 1998;339: 364-369.
40. Pelliccia A, Di Paolo FM, Corrado D, et al. Evidence for efficacy of the Italian national pre-participation screening programme for identification of hypertrophic cardiomyopathy in competitive athletes. Eur Heart J. 2006;27:2196-2200.
41. Maron BJ, Bodison SA, Wesley YE, et al. Results of screening a large group of intercollegiate competitive athletes for cardiovascular disease. J Am Coll Cardiol. 1987;10:1214-1221.
42. Pelliccia A, Culasso F, Di Paolo FM, et al. Prevalence of abnormal electrocardiograms in a large, unselected population undergoing preparticipation cardiovascular screening. Eur Heart J. 2007;28: 2006-2010.
43. McLeod CJ, Ackerman MJ, Nishimura RA, et al. Outcome of patients with hypertrophic cardiomyopathy and a normal electrocardiogram. J Am Coll Cardiol. 2009;54:229-233.
44. Drezner J, Pluim B, Engebretsen L. Prevention of sudden cardiac death in athletes: new data and modern perspectives confront challenges in the 21st century. Br J Sports Med. 2009;43:625-626.
45. Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J. 2010;31:243-259.
46. Melacini P, Cianfrocca C, Calore C, et al. Marginal overlap between electrocardiographic abnormalities in patients with hypertrophic cardiomyopathy and trained athletes: implications for preparticipation screening [abstract 3390]. Circulation. 2007;116:765.
47. Sathanandam S, Zimmerman F, Davis J, et al. ECG screening criteria for LVH does not correlate with diagnosis of hypertrophic cardiomyopathy [abstract 2484]. Circulation. 2009;120:S647.
48. Fuller CM. Cost effectiveness analysis of screening of high school athletes for risk of sudden cardiac death. Med Sci Sports Exerc. 2000;32: 887-890.
49. Drezner JA. Contemporary approaches to the identification of athletes at risk for sudden cardiac death. Curr Opin Cardiol. 2008;23: 494-501.
50. Wheeler MT, Heidenreich PA, Froelicher VF, et al. Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med. 2010;152:276-286.