• Br J Sports Med · Aug 2014

    Multicenter Study Observational Study

    Costs and yield of a 15-month preparticipation cardiovascular examination with ECG in 1070 young athletes in Switzerland: implications for routine ECG screening.

    • Andrea Menafoglio, Marcello Di Valentino, Jeanne-Marie Segatto, Patrick Siragusa, Reto Pezzoli, Mattia Maggi, Gian Antonio Romano, Giorgio Moschovitis, Matthias Wilhelm, and Augusto Gallino.
    • Division of Cardiology, Ospedale San Giovanni Bellinzona, Bellinzona, Switzerland.
    • Br J Sports Med. 2014 Aug 1; 48 (15): 1157-61.

    BackgroundThe usefulness and modalities of cardiovascular screening in young athletes remain controversial, particularly concerning the role of 12-lead ECG. One of the reasons refers to the presumed false-positive ECGs requiring additional examinations and higher costs. Our study aimed to assess the total costs and yield of a preparticipation cardiovascular examination with ECG in young athletes in Switzerland.MethodsAthletes aged 14-35 years were examined according to the 2005 European Society of Cardiology (ESC) protocol. ECGs were interpreted based on the 2010 ESC-adapted recommendations. The costs of the overall screening programme until diagnosis were calculated according to Swiss medical rates.ResultsA total of 1070 athletes were examined (75% men, 19.7±6.3 years) over a 15-month period. Among them, 67 (6.3%) required further examinations: 14 (1.3%) due to medical history, 15 (1.4%) due to physical examination and 42 (3.9%) because of abnormal ECG findings. A previously unknown cardiac abnormality was established in 11 athletes (1.0%). In four athletes (0.4%), the abnormality may potentially lead to sudden cardiac death and all of them were identified by ECG alone. The cost was 157,464 Swiss francs (CHF) for the overall programme, CHF147 per athlete and CHF14,315  per finding.ConclusionsCardiovascular preparticipation examination in young athletes using modern and athlete-specific criteria for interpreting ECG is feasible in Switzerland at reasonable cost. ECG alone is used to detect all potentially lethal cardiac diseases. The results of our study support the inclusion of ECG in routine preparticipation screening.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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