• Int. J. Clin. Pract. · Jan 2014

    Screening electrocardiograms in psychiatric research: implications for physicians and healthy volunteers.

    • A J Pavletic, M Pao, D S Pine, D A Luckenbaugh, and D R Rosing.
    • Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, USA.
    • Int. J. Clin. Pract. 2014 Jan 1; 68 (1): 117-21.

    AimsWhile there is controversy regarding utility of screening electrocardiograms (ECGs) in competitive athletes and children exposed to psychostimulants, there is no data on the use of screening ECGs in psychiatric research. We aimed to examine the prevalence and clinical significance of ECG abnormalities and their impact on eligibility for studies.MethodsWe analysed 500 consecutive ECG reports from physically healthy volunteers who had a negative cardiac history, normal cardiovascular examination and no other significant medical illnesses. For the purpose of this report, all ECGs were over-read by one cardiologist.ResultsThe mean age of our cohort was 28.3 ± 8.0 years. A total of 112 (22.4%) ECGs were reported as abnormal (14.2%) or borderline (8.2%). These abnormalities were considered clinically insignificant in all but eight subjects (1.6%) who underwent evaluation with an echocardiogram. All echocardiograms were normal. No subject was excluded from studies. After the over-reading, no abnormalities or isolated bradycardia were present in 37 of 112 (33%) ECGs that were initially reported as abnormal or borderline, while minor abnormalities were found in 7 of 204 (3.4%) ECGs that were reported as normal.ConclusionsAlthough screening ECGs did not detect significant cardiac pathology or affect eligibility for our studies, over 20% of subjects were labelled as having an abnormal or borderline ECG which was incorrect in one-third of cases. Strategies to minimise unintended consequences of screening are discussed.Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

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