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CLINICAL RESEARCH: SCREENING OF ATHLETES

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

Domenico Corrado, MD, PhD^_*,_*, Cristina Basso, MD, PhD, Maurizio Schiavon, MD, Antonio Pelliccia, MD and Gaetano Thiene, MD

^_* Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Pauda, Italy
Cardiovascular Pathology, Department of Medical-Diagnostic Sciences, University of Padua, Padua, Italy
Center for Sports Medicine and Physical Activity, Department of Social Health, ULSS 16, Padua, Italy
Institute of Sports Medicine and Science, Rome, Italy

Manuscript received March 26, 2008; revised manuscript received June 5, 2008, accepted June 6, 2008.

^_* Reprint requests and correspondence: Dr. Domenico Corrado, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Via Giustiniani, 2-35121 Padova, Italy (Email: domenico.corrado{at}unipd.it).

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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