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.
The 1996 American Heart Association consensus panel recommendations stated that pre-participation cardiovascular screening for young competitive athletes is justifiable and compelling on ethical, legal, and medical grounds. The present article represents the consensus statement of the Study Group on Sports Cardiology of the Working Group on Cardiac Rehabilitation and Exercise Physiology and the Working Group on Myocardial and Pericardial diseases of the European Society of Cardiology, which comprises cardiovascular specialists and other physicians from different European countries with extensive clinical experience with young competitive athletes, as well as with pathological substrates of sudden death. The document takes note of the 25-year Italian experience on systematic pre-participation screening of competitive athletes and focuses on relevant issues, mostly regarding the relative risk, causes, and prevalence of sudden death in athletes; the efficacy, feasibility, and cost-effectiveness of population-based pre-participation cardiovascular screening; the key role of 12-lead ECG for identification of cardiovascular diseases such as cardiomyopathies and channelopathies at risk of sudden death during sports; and the potential of preventing fatal events. The main purpose of the consensus document is to reinforce the principle of the need for pre-participation medical clearance of all young athletes involved in organized sports programmes, on the basis of (i) the proven efficacy of systematic screening by 12-lead ECG (in addition to history and physical examination) to identify hypertrophic cardiomyopathy-the leading cause of sports-related sudden death-and to prevent athletic field fatalities; (ii) the potential screening ability in detecting other lethal cardiovascular diseases presenting with ECG abnormalities. The consensus document recommends the implementation of a common European screening protocol essentially based on 12-lead ECG.
Corrado
Domenico
D
Department of Cardiology, University of Padova, Italy. domenico.corrado@unipd.it
Pelliccia
Antonio
A
Bjørnstad
Hans Halvor
HH
Vanhees
Luc
L
Biffi
Alessandro
A
Borjesson
Mats
M
Panhuyzen-Goedkoop
Nicole
N
Deligiannis
Asterios
A
Solberg
Erik
E
Dugmore
Dorian
D
Mellwig
Klaus P
KP
Assanelli
Deodato
D
Delise
Pietro
P
van-Buuren
Frank
F
Anastasakis
Aris
A
Heidbuchel
Hein
H
Hoffmann
Ellen
E
Fagard
Robert
R
Priori
Silvia G
SG
Basso
Cristina
C
Arbustini
Eloisa
E
Blomstrom-Lundqvist
Carina
C
McKenna
William J
WJ
Thiene
Gaetano
G
D000293:Adolescent; D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002985:Clinical Protocols; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D004562:Electrocardiography / Q000379:methods; D005060:Europe; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods*; D008487:Medical History Taking / Q000379:methods; D010808:Physical Examination / Q000379:methods; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013177:Sports