Conventional cardiac screening for young athletes involves routine history and physical exam. A recent cross-sectional study evaluated the effects of adding electrocardiogram (ECG) to pre-participation screening in 510 college athletes. All athletes also had transthoracic echocardiography (TTE). Of 11 athletes found to have cardiac abnormalities on TTE, 5 abnormalities were detected by conventional screening alone, and 10 were detected with the addition of ECG (level 3 [lacking direct] evidence). ECG improved the sensitivity of screening from 45.5% to 90.9% and the negative predictive value from 98.7% to 99.8%. However, ECG was also associated with an increase in false positives from 5.5% to 16.9% (Ann Intern Med 2010 Mar 2;152(5):269).
Another study evaluated the cost-effectiveness of adding ECG to the screening of high school and college athletes. ECG was associated with a cost increase of $42,000 per life-year saved, with an estimated saving of 2 life-years per 1,000 athletes screened (Ann Intern Med 2010 Mar 2;152(5):276).
For more information, see the Cardiac arrest topic in DynaMed.