National Electrocardiography Screening for Competitive Athletes: Feasible in the United States?

Sudden death in young persons, associated with partici-pation in competitive athletics, has generated consider-able visibility and concern in both the general public and medical community (1–7). Such deaths, particularly when associated with unsuspected cardiovascular disease, have become a prominent public health debate focused on strat-egies to prevent these catastrophes (8–11). Two primary prevention initiatives have evolved in an effort to create a safer athletic environment: preparticipation screening in athlete populations to identify the culprit diseases (3, 5, 12–17), and eligibility and disqualification standards to prohibit athletes identified with cardiovascular abnormali-ties from engaging in competitive sports to reduce their risk (2, 4). The efficacy of the preparticipation screening pro-cess has been scrutinized (8, 9). Substantial contribu