OBJECTIVE: To determine the effect of electrocardiogram (ECG) screening on prevention of sudden cardiac arrest and death (SCA/D) in young athletes and military members. DATA SOURCES: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19 and 7/29/19. STUDY SELECTION: Randomized and non-randomized controlled trials, where pre-participation examination including ECG was the primary intervention used to screen athletes or military 40 years of age or younger. Accepted controls were no screening, usual care, or pre-participation examination without ECG. 3 published studies , and one conference abstract were identified for inclusion. DATA EXTRACTION: In all four studies, risk of bias was assessed with the Cochrane risk of bias tool, and found to be generally high. Two studies had data extracted for random effects meta-analysis, and the remaining study and conference abstract were included in narrative review. Overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Data Synthesis: Four non-randomized studies (11,689,172 participants) were included, all at high risk of bias. Pooled data from two studies (n= 3,869,274; very low quality evidence) observed an inconclusive 42% relative decrease in risk of sudden cardiac death (RR 0.58; 95% CI 0.23, 1.45), equating to an absolute risk reduction of .0016% The findings were consistent with a potential 67% relative decrease to a 45% relative increased risk in participants screened with ECG. Heterogeneity was found to be high as measured with I2 statistic (71%). Data from the remaining study and abstract were similarly inconclusive. CONCLUSION: Existing evidence for the effect of ECG screening is inconclusive and of very low quality. Our meta-analysis observed that screening ECG may result in considerable benefit or harm to participants. Higher quality studies are needed to reduce this uncertainty. PROSPERO Registration: CRD42019125560.
OBJECTIVE: To determine the effect of electrocardiogram (ECG) screening on prevention of sudden cardiac arrest and death (SCA/D) in young athletes and military members. DATA SOURCES: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19 and 7/29/19. STUDY SELECTION: Randomized and non-randomized controlled trials, where pre-participation examination including ECG was the primary intervention used to screen athletes or military 40 years of age or younger. Accepted controls were no screening, usual care, or pre-participation examination without ECG. 3 published studies , and one conference abstract were identified for inclusion. DATA EXTRACTION: In all four studies, risk of bias was assessed with the Cochrane risk of bias tool, and found to be generally high. Two studies had data extracted for random effects meta-analysis, and the remaining study and conference abstract were included in narrative review. Overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Data Synthesis: Four non-randomized studies (11,689,172 participants) were included, all at high risk of bias. Pooled data from two studies (n= 3,869,274; very low quality evidence) observed an inconclusive 42% relative decrease in risk of sudden cardiac death (RR 0.58; 95% CI 0.23, 1.45), equating to an absolute risk reduction of .0016% The findings were consistent with a potential 67% relative decrease to a 45% relative increased risk in participants screened with ECG. Heterogeneity was found to be high as measured with I2 statistic (71%). Data from the remaining study and abstract were similarly inconclusive. CONCLUSION: Existing evidence for the effect of ECG screening is inconclusive and of very low quality. Our meta-analysis observed that screening ECG may result in considerable benefit or harm to participants. Higher quality studies are needed to reduce this uncertainty. PROSPERO Registration: CRD42019125560.
Authors: Barry J Maron; Paul D Thompson; Michael J Ackerman; Gary Balady; Stuart Berger; David Cohen; Robert Dimeff; Pamela S Douglas; David W Glover; Adolph M Hutter; Michael D Krauss; Martin S Maron; Matthew J Mitten; William O Roberts; James C Puffer Journal: Circulation Date: 2007-03-12 Impact factor: 29.690
Authors: Jonathan A Drezner; David S Owens; Jordan M Prutkin; Jack C Salerno; Kimberly G Harmon; Shelley Prosise; Alana Clark; Irfan M Asif Journal: Am J Cardiol Date: 2016-06-14 Impact factor: 2.778
Authors: Antonio Pelliccia; Sanjay Sharma; Sabiha Gati; Maria Bäck; Mats Börjesson; Stefano Caselli; Jean-Philippe Collet; Domenico Corrado; Jonathan A Drezner; Martin Halle; Dominique Hansen; Hein Heidbuchel; Jonathan Myers; Josef Niebauer; Michael Papadakis; Massimo Francesco Piepoli; Eva Prescott; Jolien W Roos-Hesselink; A Graham Stuart; Rod S Taylor; Paul D Thompson; Monica Tiberi; Luc Vanhees; Matthias Wilhelm Journal: Eur Heart J Date: 2021-01-01 Impact factor: 29.983
Authors: Jonathan A Drezner; Sanjay Sharma; Aaron Baggish; Michael Papadakis; Mathew G Wilson; Jordan M Prutkin; Andre La Gerche; Michael J Ackerman; Mats Borjesson; Jack C Salerno; Irfan M Asif; David S Owens; Eugene H Chung; Michael S Emery; Victor F Froelicher; Hein Heidbuchel; Carmen Adamuz; Chad A Asplund; Gordon Cohen; Kimberly G Harmon; Joseph C Marek; Silvana Molossi; Josef Niebauer; Hank F Pelto; Marco V Perez; Nathan R Riding; Tess Saarel; Christian M Schmied; David M Shipon; Ricardo Stein; Victoria L Vetter; Antonio Pelliccia; Domenico Corrado Journal: Br J Sports Med Date: 2017-03-03 Impact factor: 13.800
Authors: Kimberly G Harmon; Irfan M Asif; Joseph J Maleszewski; David S Owens; Jordan M Prutkin; Jack C Salerno; Monica L Zigman; Rachel Ellenbogen; Ashwin L Rao; Michael J Ackerman; Jonathan A Drezner Journal: Mayo Clin Proc Date: 2016-09-28 Impact factor: 7.616
Authors: Elizabeth A Williams; Hank F Pelto; Brett G Toresdahl; Jordan M Prutkin; David S Owens; Jack C Salerno; Kimberly G Harmon; Jonathan A Drezner Journal: J Am Heart Assoc Date: 2019-07-09 Impact factor: 5.501