November 19, 2014 Leave a comment
Screening for sudden cardiac death (SCD) remains one of the more contentious debates in the world of sports medicine. As a matter of public policy, consensus medical opinion in the United States still argues against universal, mandatory screening with electrocardiograms (ECGs); whereas in Europe, specifically in Italy, ECG screening is more of a routine practice.
The debate over this screening is carried on at many conferences and in many medical journals, including ours. We’ve previously looked at the question of whether it makes sense to screen North American athletes with ECGs, for instance. Earlier this year, we published a review of the different approaches American universities are currently using regarding the issue of athletic cardiovascular screening. Recently, the topic came up in the podcast discussion I had with Dr. William Roberts on new directions for the pre-participation evaluation (PPE). American and European sport medicine bodies can find a lot of common ground in where the PPE can be improved, according to Dr. Roberts, with the principal exception of this one issue.
Recently, Dr. Sami Viskin, from the Department of Cardiology, Tel Aviv Medical Center, spoke at my home institution about how athletes are screened for SCD in Israel. He has written extensively on the issue of screening athletes for SCD, including a study arguing that it is not a cost-effective strategy in the United States. The title of his recent talk: “Mandatory ECG screening of athletes saves lives: proven fact or wishful thinking?”
Our Division of Sports Medicine has been hosting another international guest this past month: Dr. Jose Angel Garza, a sports medicine physician from the University Hospital of the Universidad Autonoma de Nuevo Leon (UANL) in Monterrey, Mexico. He was also present at Dr. Viskin’s talk, and I asked him for his reflections on the subject of mandatory ECG screening in athletes.
Among the sports medical community, there is an ongoing and often heated debate on whether mandatory ECG screening should be performed on athletes. Several countries such as Italy and Israel have implemented such measures. The European Society of Cardiology has issued recommendations about mandatory screening of athletes with ECG. So this begs the question: Does ECG screening save lives in athletes? Read more of this post