The Impending Dilemma of Electrocardiogram Screening in Athletic Children.
Sudden cardiac death (SCD) affects 2/100,000 young, active athletes per year of which 40% are less than 18 years old. In 2004, the International Olympic Committee accepted the Lausanne Recommendations, including a 12-lead electrocardiogram (ECG), as a pre-participation screening tool for adult Olympic athletes. The debate on extending those recommendations to the pediatric population has recently begun. The aims of our study were to highlight the characteristics of the young athlete ECG, phenotypical manifestations of SCD-related disease in children, and challenges of implanting ECG screening in athletic children. A systematic review of the literature is performed. We searched available electronic medical databases for articles relevant to SCD, ECG, silent cardiac diseases, and athletic children. We focused on ECG screening and description in a pediatric population. We identified 2240 studies. Sixty-two relevant articles and one book were selected. In children, prepubertal ECG and the ECG phenotype of most SCD-related diseases differ notably from adults. The characteristics of the prepubertal ECG and of the phenotypical manifestation of SCD-related disease in children will result in less specific and less sensitive ECG-based screening programs. Those limitations advise against extending the adult recommendation to children, without further studies. Until then, history and physical exam should remain the cornerstone of screening for SCD-related pathologies in children.
Pediatrics Department, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
Laure
L
Léger
La Tour Sport Medicine, Hôpital de La Tour, Meyrin, Switzerland.|Swiss Olympic Medical Center, Department for Locomotion, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
Boris
B
Gojanovic
Cardiology Division, Pediatrics Department, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.
Nicole
N
Sekarski
Cardiology Division, Pediatrics Department, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.|Pediatric Cardiology, Twente University, Enschede, Netherland.
Erik J
EJ
Meijboom
Cardiology Division, Pediatrics Department, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland. Yvan.Mivelaz@chuv.ch.
Yvan
http://orcid.org/0000-0002-3507-6879
Y
Mivelaz
D000293:Adolescent; D000328:Adult; D056352:Athletes; D002648:Child; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography / Q000379:methods*; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D013177:Sports; D055815:Young Adult
Athletes; Childhood; ECG; Pre-participation; Screening; Sport; Sudden cardiac death