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Preventive screening for sudden cardiac death in young athletes debated
Date:11/26/2012

While ensuring the safety of high school and college athletes is hardly controversial, the method and associated costs of doing so are hotly debated. Conducting electrocardiographic (ECG) screenings of all young competitive athletes in the United States would cost up to $69 billion over 20 years and save about 4,813 lives, making the cost per life saved over $10 million, according to a study published online today in the Journal of the American College of Cardiology.

A corresponding editorial suggests that this number is inflated and "misleading" and blames the high costs on cultural attitudes and medical policies on preventative medicine in the United States. The issue has been widely debated among experts currently in sports cardiology, a growing field of medicine in the United States. The European Society of Cardiology recommends mandatory ECG screening of all competitive athletes, but the American Heart Association recommends a physical exam and family history questionnaire as a first-line screening, with further examination based on the results of those initial steps.

"While this research focuses on the monetary costs of mandatory ECG screening, it is important to consider the human costs of false positives, which can result in additional potentially unnecessary tests and removal from play of athletes who are not actually at risk," said ACC President William Zoghbi, MD, FACC. "Most in this discussion agree that physicals, thorough family histories, targeted testing with ECG and other modalities when needed, widespread training in CPR, and availability of automated external defibrillators save lives from sudden cardiac arrest."

A 2006 Italian observational study found that mandatory ECG-based screening of athletes implemented by Italian law led, over a 20-year period, to a 89 percent relative risk reduction in sudden cardiac death; however, the absolute risk reduction, the cost and the economic ramifications have not been
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Contact: Nicole Napoli
nnapoli@acc.org
202-375-6523
American College of Cardiology
Source:Eurekalert

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