The 6th Congress of Exercise and Sport Sciences

Mandatory Electrocardiographic Screening of Athletes to Reduce Their Risk of Sudden Death: Proven Fact or Wishful Thinking

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Department of Cardiology. Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Sudden cardiac death in young athletes is a tragic event. Because most cases are the result of ventricular arrhythmias caused by underlying heart disease, an increasing number of countries, including Israel, enforce pre-participation screening that includes recording of a baseline electrocardiogram (ECG), with the aim of detecting asymptomatic cardiac disease associated with sudden death in athletes. In fact, mandatory ECG screening of athletes is endorsed by the International Olympic Committee and the European Society of Cardiology. However, the evidence showing that such a strategy actually prevents sudden death is limited to a single, Italian study reporting that that the annual incidence of sudden death among athletes decreased from 3.6 to 0.4 per 100,000 person-years following 20 years of screening. That study, however, was plagued by limitations related to its retrospective design, including the impact of improved resuscitation over time and a possible “immortal time bias.” Moreover, we found that enforcement of the law mandating preparticipation ECG screening of athletes has had no appreciable impact on the risk of sport-related sudden death in Israel. Furthermore, we found that life-threatening events related to heat stroke (obviously unpredictable with ECG screening), are 10-times more common than cardiac-related adverse-events during endurance sports in Israel.

Sami Viskin
Sami Viskin








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