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Guidelines for Sudden Cardiac Death Reviewed

Need for international consensus to prevent cardiovascular death in young athletes

TUESDAY, Dec. 2 (HealthDay News) -- Most European cardiology societies and sports federations require electrocardiograms for pre-participation screening of athletes, but U.S. guidelines do not, according to two reports published in the Dec. 9 issue of the Journal of the American College of Cardiology.

Based on an analysis of data from the 25-year screening program in Italy, Domenico Corrado, M.D., Ph.D., of the University of Padua, and colleagues report that electrocardiographic screening has reduced sudden cardiac death in Italian athletes by approximately 90 percent by effectively detecting lethal cardiomyopathies and arrhythmias. They suggest that there is a need for cardiovascular risk management via universal public health screening among athletes worldwide.

In a related study, Antonio Pelliccia, M.D., of the Italian National Olympic Committee in Rome, and colleagues report that unlike the U.S. guidelines, the European Society of Cardiology panel restricted genotype-positive, phenotype-negative athletes with hypertrophic cardiomyopathy, Brugada syndrome, long-QT syndrome, and Marfan syndrome from participation. Also, the authors note that medical clearance for cardiovascular ailments among high school or college athletes in the United States is not governed by Federal or state laws.

"To develop a single international consensus, experts would have to reach agreement on the cardiovascular risks of competitive athletics and the recommended procedures and personnel involved in screening for possible disease, and adopt similar policies restricting participation in those at risk," Pamela S. Douglas, M.D., of Duke University in Durham, N.C., writes in an accompanying editorial.

Abstract - Corrado
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Abstract - Pelliccia
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