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A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening

Published online by Cambridge University Press:  10 October 2016

Angira Patel ,
Gregory Webster ,
Kendra Ward  and
John Lantos
Angira Patel*
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Gregory Webster
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Kendra Ward
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
John Lantos
Affiliation:
Children’s Mercy Bioethics Center, Kansas City, Missouri, United States of America
*
Correspondence to: A. Patel, MD, MPH, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue, Box 21, Chicago, IL 60611, United States of America. Tel: +312 227 4100; Fax: +312 227 9640; E-mail: [email protected]
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Abstract

Aim

The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE).

Methods

Paediatricians affiliated with a tertiary children’s hospital completed a survey about ECGs for PPSE.

Results

In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die. Only 16% of paediatricians perform all 12 American Heart Association recommended elements of the PPSE. If any of these screening elements are abnormal, 69% obtain an ECG, 36% an echocardiogram, and 30% restrict patients from sports activity; 73% of them refer the patient to a cardiologist.

Conclusion

Most of the general paediatricians surveyed did not currently perform ECGs for PPSE. In addition, there was a low rate of adherence to performing the 12 screening elements recommended by the American Heart Association. They have trouble obtaining timely, accurate ECG interpretations, worry about potential unnecessary exercise restrictions, and cost-effectiveness. The practical hurdles to ECG implementation emphasise the need for a fresh look at PPSE, and not just ECG screening. Improvements in ECG performance/interpretation would be necessary for ECGs to be a useful part of PPSE.

Keywords

Electrocardiogramscreeningsurveypaediatrician
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 884 - 889
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Copyright
© Cambridge University Press 2016 

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References

1. Bernhardt, DT, Roberts, WO. Preparticipation Physical Evaluation, 4th edn. American Academy of Pediatrics, Chicago, IL, USA, 2010.Google Scholar
2. Chaitman, BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation 2007; 116: 2610–2614; Discussion 5.CrossRefGoogle Scholar
3. Corrado, D, Thiene, G. Protagonist: routine screening of all athletes prior to participation in competitive sports should be mandatory to prevent sudden cardiac death. Heart Rhythm 2007; 4: 520–524.CrossRefGoogle ScholarPubMed
4. Maron, BJ, Friedman, RA, Kligfield, P, et al. Assessment of the 12-lead electrocardiogram 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 of Cardiology. J Am Coll Cardiol 2014; 64: 1479–1514.CrossRefGoogle ScholarPubMed
5. Corrado, D, 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.CrossRefGoogle Scholar
6. Drezner, JA. ECG screening in athletes: time to develop infrastructure. Heart Rhythm 2011; 8: 1560–1561.CrossRefGoogle ScholarPubMed
7. Maron, BJ. How should we screen competitive athletes for cardiovascular disease? Eur Heart J 2005; 26: 428–430.CrossRefGoogle ScholarPubMed
8. Maron, BJ. Counterpoint/mandatory ECG screening of young competitive athletes. Heart Rhythm 2012; 9: 1897.CrossRefGoogle ScholarPubMed
9. Drezner, J, Corrado, D. Is there evidence for recommending electrocardiogram as part of the pre-participation examination? Clinical journal of sport medicine. Clin J Sport Med 2011; 21: 18–24.CrossRefGoogle Scholar
10. Maron, BJ. National electrocardiography screening for competitive athletes: feasible in the United States? Ann Intern Med 2010; 152: 324–326.CrossRefGoogle ScholarPubMed
11. Wheeler, MT, Heidenreich, PA, Froelicher, VF, Hlatky, MA, Ashley, EA. Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med 2010; 152: 276–286.CrossRefGoogle ScholarPubMed
12. Pfister, GC, Puffer, JC, Maron, BJ. Preparticipation cardiovascular screening for US collegiate student-athletes. JAMA 2000; 283: 1597–1599.CrossRefGoogle ScholarPubMed
13. Wingfield, K, Matheson, GO, Meeuwisse, WH. Preparticipation evaluation: an evidence-based review. Clin J Sport Med 2004; 14: 109–122.CrossRefGoogle ScholarPubMed
14. Schmied, C, Borjesson, M. Sudden cardiac death in athletes. J Intern Med 2014; 275: 93–103.CrossRefGoogle ScholarPubMed
15. 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.CrossRefGoogle ScholarPubMed
16. Harmon, KG, Zigman, M, Drezner, JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis. J Electrocardiol 2015; 48: 329–338.CrossRefGoogle ScholarPubMed
17. Maron, BJ, Shirani, J, Poliac, LC, Mathenge, R, Roberts, WC, Mueller, FO. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA 1996; 276: 199–204.CrossRefGoogle ScholarPubMed
18. Maron, BJ. Sudden death in young athletes. N Engl J Med 2003; 349: 1064–1075.CrossRefGoogle ScholarPubMed
19. Corrado, D, Basso, C, Thiene, G. Essay: sudden death in young athletes. Lancet (London, England) 2005; 366 (Suppl 1): S47–S48.CrossRefGoogle ScholarPubMed
20. Wong, LC, Roses-Noguer, F, Till, JA, Behr, ER. Cardiac evaluation of pediatric relatives in sudden arrhythmic death syndrome: a 2-center experience. Circ Arrhythm Electrophysiol 2014; 7: 800–806.CrossRefGoogle ScholarPubMed
21. Behr, ER, Casey, A, Sheppard, M, et al. Sudden arrhythmic death syndrome: a national survey of sudden unexplained cardiac death. Heart 2007; 93: 601–605.CrossRefGoogle ScholarPubMed
22. Driscoll, DJ, Edwards, WD. Sudden unexpected death in children and adolescents. J Am Coll Cardiol 1985; 5 (Suppl 6): 118b–121b.CrossRefGoogle ScholarPubMed
23. Retrieved February 17, 2016, from http://www.nfhs.org/ParticipationStatistics/PDF/2014-15_Participation_Survey_Results.pdf Google Scholar
24. Retrieved February 18, 2016, from https://www.nhlbi.nih.gov/news/press-releases/2013/nih-and-cdc-launch-registry-for-sudden-death-in-the-young Google Scholar
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