There’s no doubt that 12-lead electrocardiography (ECG) screening can spot life-threatening heart abnormalities in athletes. However, most schools and sports organizations in the U.S. say that administering screening is too costly for their programs and that requiring young athletes’ families to pay for ECG screenings themselves would discourage participation in sports.
ECG screenings for young athletes may result in significant life-years saved. (Photo: iStock)
Two recent articles in leading journals challenge that view and suggest that the benefits of ECG screenings for athletes may outweigh the upfront costs.
An study published in the March 2 issue of the Annals of Internal Medicine examined data on high school and college athletes ages 14 to 22 years. The research determined that screening with a medical history and a physical exam, at a cost of $111 per athlete, had a relatively small result (expressed as .56 life-years per 1,000 athletes). Adding an ECG (an additional $89 per person), however, saved 2.06 more life-years per 1,000 athletes. The New York Times, reporting on the EKG study, noted that the cost of ECG screening per life-year saved turned out to be comparable to the costs and benefits of making kidney dialysis available.
In January, sections of Sports Cardiology and Exercise Physiology of the European Association of Cardiovascular Prevention and the European Society of Cardiology released a position statement on ECG screening for athletes. (Recommendation for interpretation of 12-lead electrocardiogram in the athlete. Corrado, et al. European Heart Journal. Jan, 2010. 31,243-259.)
The journal article notes that two types of cardiovascular abnormalities may be detected in athletes. One type is caused by adaptive changes in the heart resulting from athletic training (“cardiovascular remodeling”). The other type is caused by underlying conditions that put the athlete at risk for sudden cardiac death.
“ECG may be abnormal in up to 50% of athletes,” the article said. However, the authors conclude that by gaining a greater understanding of the range of abnormalities and how they appear in ECG results, clinicians can be more accurate in interpreting ECG results — thereby increasing the value of ECG screening in preventing sudden cardiac death.
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Thu, Mar 4, 2010 |
Cardiology, ECG