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Electrocardiography Effective in Pre-Athletic Screenings

Exercise test reveals cardiac anomalies undetected by resting ECG and may help prevent sudden deaths

MONDAY, July 7 (HealthDay News) -- Among people seeking to obtain clinical eligibility for participation in competitive sports, exercise electrocardiography (ECG) screening can identify silent cardiovascular disorders that are undetected by resting ECG, according to the results of a study published July 3 in BMJ Online First.

Francesco Sofi, M.D., of the University of Florence, Italy, and colleagues screened 30,065 subjects including 23,570 men.

The researchers found that exercise ECG identified cardiac anomalies in 1,227 subjects whose resting ECG results were normal. Of the 159 subjects who were disqualified at the end of the screening for cardiac reasons, they found that 126 (79.2 percent) had innocent or negative resting ECG results but showed clear signs of cardiac anomalies during exercise ECG.

"An important element of Sofi and colleagues' study is that only a small proportion (1.2 percent) of athletes had distinct abnormalities identified on resting ECG," state the authors of an accompanying editorial. "As a result, false positives were few. Importantly, 153 of the 159 true positives involving athletes ultimately disqualified from sport with an identified cardiovascular disorder would have been overlooked on history and physical examination alone. Thus, although a detailed personal and family history and physical examination will detect an important but limited number of athletes with underlying cardiovascular disease, adding ECG to the screening process will detect more athletes with silent cardiovascular disorders at risk of sudden death."

The author of the editorial is on the board for Parent Heart Watch, Sudden Cardiac Arrest Association, and Heart Screen America.

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