AA Systematic Review M J T

Abstract: No matter how rare, the death of young athletes is a tragedy. Can it be prevented? The European experience suggests that adding the electrocardiogram (ECG) to the standard medical and family history and physical examina-tion can decrease cardiac deaths by 90%. However, there has not been a randomized trial to demonstrate such a reduction. While there are obvious differences between the European and American experiences with athletes including very differing causes of athletic deaths, some would highlight the European emphasis on public welfare vs the protection of personal rights in the USA. Even the authors of this systematic review have differing interpretation of the data: some of us view screening as a hopeless battle against Bayes, while others feel that the ECG can save lives. What we all agree on is that the USA should implement the American Heart Association 12-point screening recommendations and that, before ECG screening is mandated, we need to gather more data and optimize ECG criteria for screening young athletes. (Curr Probl Cardiol 2009;34:586-662.) he benefits of adding an electrocardiogram (ECG) to the prepar-ticipation examination (PPE) of young, competitive athletes re-main controversial. High public visibility of athletic deaths and impact on families who lose an athlete in the prime of life and healt