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Screening the apparently healthy athlete for risk: a paradigm in transition

Published online by Cambridge University Press:  13 January 2017

Joshua D. Kurtz ,
Ronald J. Kanter ,
Melissa Olen  and
Anthony F. Rossi
Joshua D. Kurtz*
Affiliation:
Department of Pediatrics, Nicklaus Children’s Hospital, Miami, FL, United States of America
Ronald J. Kanter
Affiliation:
Department of Pediatrics, Nicklaus Children’s Hospital, Miami, FL, United States of America
Melissa Olen
Affiliation:
Department of Pediatrics, Nicklaus Children’s Hospital, Miami, FL, United States of America
Anthony F. Rossi
Affiliation:
Department of Pediatrics, Nicklaus Children’s Hospital, Miami, FL, United States of America
*
Correspondence to: J. D. Kurtz, MD, Department of Pediatrics, Nicklaus Children’s Hospital, 3100 SW 62nd Avenue, Miami, FL 33156, United States of America. Tel: +305 669 5873; Fax: +305 669 6531; E-mail: Joshua.Kurtz@mch.com
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Abstract

It has largely been accepted that pre-participation screening for student athletes is necessary, but there is still no consensus on the most effective and efficient ways to accomplish this. Most clinical strategies are based on retrospective case series. By applying the European Society of Cardiology and Seattle criteria, electrocardiography appears to afford the lowest false-positive rate for identifying potentially dangerous cardiac abnormalities in athletes. Prospective, randomised trials may help determine the most effective primary prevention. Normative data for age, gender, and ethnicity for screening tools need to be formulated to further reduce false-positive results. Targeted advanced screening aimed at the highest risk groups may be the most beneficial and cost-effective application of primary prevention.

Keywords

Sudden cardiac deathsudden cardiac arrestprimary preventionelectrocardiogramechocardiogram
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Supplement S1: Sudden Cardiac Arrest in the Young: A Contemporary Perspective , January 2017 , pp. S89 - S93
Copyright
© Cambridge University Press 2017 

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References

1. Harmon, KG, Asif, IM, Klossner, D, Drezner, JA. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation 2011; 123: 1594–1600.Google Scholar
2. Steinvil, A, Chundadze, T, Zeltser, D, et al. Mandatory electrocardiographic screening of athletes to reduce their risk for sudden death proven fact or wishful thinking? . J Am Coll Cardiol 2011; 57: 1291–1296.Google Scholar
3. Corrado, D, Basso, C, Pavei, A, Michieli, P, Schiavon, M, Thiene, G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006; 296: 1593–1601.Google Scholar
4. Maron, BJ, Doerer, JJ, Haas, TS, Tierney, DM, Mueller, FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation 2009; 119: 1085–1092.CrossRefGoogle ScholarPubMed
5. Toresdahl, BG, Rao, AL, Harmon, KG, Drezner, JA. Incidence of sudden cardiac arrest in high school student athletes on school campus. Heart Rhythm 2014; 11: 1190–1194.Google Scholar
6. Baggish, AL, Hutter, AM, Wang, F, et al. Cardiovascular screening in college athletes with and without electrocardiography. A cross-sectional study. Ann Intern Med 2010; 152: 269–275.Google Scholar
7. 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: 1643–1655.Google Scholar
8. Maron, BJ, Friedman, RA, Kligfield, P, et al. Assessment of the 12-lead ECG as a screening test for detection of cardiovascular disease in healthy general populations of young people (12–25 years of age): a scientific statement from the American Heart Association and the American College Cardiology. Circulation 2014; 130: 1303–1334.Google Scholar
9. Corrado, J, Pelliccia, A, Bjornstad, HH, et al. Cardiovascular pre-participation 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.Google Scholar
10. Bille, K, Schamasch, P, Kappenberger, L, et al. Sudden deaths in athletes: the basis for the “Lausanne Recommendations” of the International Olympic Committtee. Circulation 2005; 112: II-830, Abstract.Google Scholar
11. Roberts, WO, Stovitz, SD. Incidence of sudden cardiac death in Minnesota high school athletes 1993–2012 screened with a standardized pre-participation evaluation. J Am Coll Cardiol 2013; 62: 1298–1301.Google Scholar
12. Asif, IM, Johnson, S, Schmieg, J, et al. The psychological impact of cardiovascular screening: the athlete’s perspective. Br J Sports Med 2014; 48: 1162–1166.Google Scholar
13. Vetter, VL, Dugan, N, Guo, R, et al. A pilot study of the feasibility of heart screening for sudden cardiac arrest in healthy children. Am Heart J 2011; 161: 1000–1006.Google Scholar
14. Drezner, JA, Ackerman, MJ, Cannon, BC, et al. Abnormal electrocardiographic findings in athletes: recognising changes suggestive of primary electrical disease. Br J Sports Med 2013; 47: 153–167.Google Scholar
15. Corrado, D, Pellicia, A, Heidbuchel, H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010; 31: 243–259.CrossRefGoogle ScholarPubMed
16. Drezner, JA, Ackerman, MJ, Anderson, J, et al. Electrocardiographic interpretation in athletes: the ‘Seattle criteria’. Br J Sports Med 2013; 47: 122–124.Google Scholar
17. Sharma, S, Merghani, A, Gati, S. Cardiac screening of young athletes prior to participation in sports: difficulties in detecting the fatally flawed among the fabulously fit. JAMA Intern Med 2015; 175: 125–127.Google Scholar
18. Shephard, RJ. Is electrocardiogram screening of North American athletes now warranted? Clin J Sport Med 2011; 21: 189–191.CrossRefGoogle ScholarPubMed
19. Maron, BJ, Murphy, CJ, Haas, TS, Ahluwalia, A, Garberich, RF. Strategies for assessing the prevalence of cardiovascular sudden deaths in young competitive athletes. Int J Cardiol 2014; 173: 369–372.Google Scholar