title: Prevalence of electrocardiographic anomalies in young individuals: relevance to a nationwide cardiac screening program.
abstract: OBJECTIVE
  This study sought to investigate the prevalence of potentially abnormal electrocardiographic (ECG) patterns in young individuals to assess the implications for a nationwide screening program for conditions causing sudden cardiac death (SCD).
  
  
  BACKGROUND
  The Italian experience suggests that pre-participation screening with ECG reduces the incidence of SCD in athletes. However, the majority of SCDs occur in nonathletes. In the United Kingdom, screening for cardiac disorders is confined to symptomatic individuals or those with a family history of inherited cardiac conditions or premature cardiac death.
  
  
  METHODS
  Between 2008 and 2012, 7,764 nonathletes ages 14 to 35 years underwent ECG screening. Electrocardiograms were analyzed for group 1 (training-related) and group 2 (potentially pathological) patterns presented in the 2010 European Society of Cardiology position paper, which advocates further evaluation for individuals with group 2 ECG patterns. Results were compared with 4,081 athletes.
  
  
  RESULTS
  Group 1 patterns occurred in 49.1% of nonathletes and 87.4% of athletes (p < 0.001). Group 2 patterns occurred in 21.8% of nonathletes and 33% of athletes (p < 0.001). In nonathletes, QTc interval abnormalities comprised the majority (52%) of group 2 changes, whereas T-wave inversions constituted 11%. Male sex and African/Afro-Caribbean ethnicity demonstrated the strongest association with group 2 ECG patterns.
  
  
  CONCLUSIONS
  The study demonstrates that 1 in 5 young people have group 2 ECG patterns. The low incidence of SCD in young people suggests that in most instances such patterns are non-specific. These findings have significant implications on the feasibility and cost-effectiveness of nationwide screening programs for cardiovascular disease in young nonathletes and athletes alike, on the basis of current guidelines.
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom; University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: Navin
authors.initials: N
authors.lastname: Chandra
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bastiaenen
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom; University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Papadakis
authors.affiliation: University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: Vasileios F
authors.initials: VF
authors.lastname: Panoulas
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom.
authors.forename: Saqib
authors.initials: S
authors.lastname: Ghani
authors.affiliation: University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Duschl
authors.affiliation: University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Foldes
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom.
authors.forename: Hariharan
authors.initials: H
authors.lastname: Raju
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom; University Hospital Lewisham, Department of Cardiology, London, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Osborne
authors.affiliation: St George's University of London, Division of Cardiac and Vascular Sciences, London, United Kingdom; University Hospital Lewisham, Department of Cardiology, London, United Kingdom. Electronic address: ssharma21@hotmail.com.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: electrocardiogram; ethnicity; pre-participation screening; sudden cardiac death