Costs and yield of a 15-month preparticipation cardiovascular examination with ECG in 1070 young athletes in Switzerland: implications for routine ECG screening

Menafoglio, A.; Di Valentino, M.; Segatto, J.-M.; Siragusa, P.; Pezzoli, R.; Maggi, M.; Romano, G. A.; Moschovitis, G.; Wilhelm, Matthias; Gallino, A. (2014). Costs and yield of a 15-month preparticipation cardiovascular examination with ECG in 1070 young athletes in Switzerland: implications for routine ECG screening. British journal of sports medicine, 48(15), pp. 1157-1161. BMJ Publishing Group 10.1136/bjsports-2013-092929

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Background The usefulness and modalities of cardiovascular screening in young athletes remain controversial, particularly concerning the role of 12-lead ECG. One of the reasons refers to the presumed false-positive ECGs requiring additional examinations and higher costs. Our study aimed to assess the total costs and yield of a preparticipation cardiovascular examination with ECG in young athletes in Switzerland. Methods Athletes aged 14–35 years were examined according to the 2005 European Society of Cardiology (ESC) protocol. ECGs were interpreted based on the 2010 ESC-adapted recommendations. The costs of the overall screening programme until diagnosis were calculated according to Swiss medical rates. Results A total of 1070 athletes were examined (75% men, 19.7±6.3 years) over a 15-month period. Among them, 67 (6.3%) required further examinations: 14 (1.3%) due to medical history, 15 (1.4%) due to physical examination and 42 (3.9%) because of abnormal ECG findings. A previously unknown cardiac abnormality was established in 11 athletes (1.0%). In four athletes (0.4%), the abnormality may potentially lead to sudden cardiac death and all of them were identified by ECG alone. The cost was 157 464 Swiss francs (CHF) for the overall programme, CHF147 per athlete and CHF14 315  per finding. Conclusions Cardiovascular preparticipation examination in young athletes using modern and athlete-specific criteria for interpreting ECG is feasible in Switzerland at reasonable cost. ECG alone is used to detect all potentially lethal cardiac diseases. The results of our study support the inclusion of ECG in routine preparticipation screening.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Wilhelm, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0306-3674

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

David Herzig

Date Deposited:

13 Mar 2015 10:22

Last Modified:

28 Oct 2015 11:28

Publisher DOI:

10.1136/bjsports-2013-092929

PubMed ID:

24505042

URI:

https://boris.unibe.ch/id/eprint/64464

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