Background: The role of electrocardiographic (ECG) in pre-participation screening of athletes is debated. One may learn about the expected efficacy of ECG screening for preventing sudden death by focusing on the percentage of athletes who are disqualified as a result of screening. We therefore evaluated a very large population of athletes and non-athletes who underwent thorough screening. We focused on the test that lead to additional evaluation and eventual disqualification.
Methods: We reviewed the data for >60,000 subjects who underwent screening at the Wingate Institute in Israel during a 14-year period. The screened population included competitive athletes as well as non-athletes requesting medical screening. The screening process was uniform and included a medical questionnaire, physical examination, resting ECG and exercise test.
Results: A total of 20,102 athletes and 41,084 non-athletes underwent screening. Abnormal initial screening led to additional tests in 1714 (8.5%) athletes and 11,880 (29%) non-athletes. When supplementary tests were requested, the most common was echocardiography (90%). An ultimate disqualifying diagnosis was reached for 700 (3.5%) athletes and 2008 (4.9%) non-athletes, p
Conclusion: When similar screening tests are applied to athletes and non-athletes of young age, a high percentage of screened individuals that is actually higher for non-athletes, are referred for additional testing. The ultimate diagnosis leading to disqualification is a cardiac disease in the majority of disqualified athletes. The screening test starting the process ultimately leading to disqualification from sport participation was an abnormal ECG in only 1 out of 4 disqualified athletes.
