Clinical Research
Screening of Athletes
Pre-Participation Screening of Young Competitive Athletes for Prevention of Sudden Cardiac Death

https://doi.org/10.1016/j.jacc.2008.06.053Get rights and content
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In 1982 a nationwide program of pre-participation screening including 12-lead electrocardiography (ECG) was launched in Italy. The aim of this article is to examine whether this 25-year screening program should be considered a valid and advisable public health strategy. The analysis of data coming from the long-running Italian experience indicates that ECG screening has provided adequate sensitivity and specificity for detection of potentially lethal cardiomyopathy or arrhythmias and has led to substantial reduction of mortality of young competitive athletes by approximately 90%. Screening was feasible thanks to the Italian Health System, which is developed in terms of health care and prevention services, and because of the limited costs of cardiovascular evaluation in the setting of a mass program. On the basis of current scientific evidence the implementation of a mass-screening program aimed to prevent athletic-field sudden cardiac death should be at least carefully considered by public health administrators worldwide.

Key Words

cardiomyopathy
electrocardiogram
sudden death

Abbreviations and Acronyms

ARVC/D
arrhythmogenic right ventricular cardiomyopathy/dysplasia
HCM
hypertrophic cardiomyopathy
SCD
sudden cardiac death
YCA
young competitive athlete

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This work was supported by the Ministry of Health, Rome; Fondazione Cariparo, Padova and Rovigo; and Registry of Cardio-cerebro-vascular Pathology, Veneto Region, Venice, Italy.