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Is There Evidence for Recommending Electrocardiogram as Part of the Pre-Participation Examination?

Drezner, Jonathan MD*; Corrado, Domenico MD, PhD

Clinical Journal of Sport Medicine: January 2011 - Volume 21 - Issue 1 - p 18-24
doi: 10.1097/JSM.0b013e318205dfb2
Thematic Issue

Sudden cardiac death (SCD) is the leading cause of death in young athletes on the playing field and typically the result of undiagnosed structural or electrical cardiovascular disease. Cardiovascular screening in athletes is routinely practiced and endorsed by most major sporting and medical associations, but universal agreement on a single screening strategy to identify athletes at risk for SCD remains a topic of tremendous debate. The pool of scientific evidence supporting the efficacy and cost-effectiveness of electrocardiogram (ECG) screening for athletes is growing. However, feasibility and practical concerns regarding false-positive results, cost-effectiveness, physician infrastructure, and health care resources for large-scale implementation of ECG screening still exist. This article examines the evidence related to ECG screening in athletes and presents a contemporary model for primary prevention of SCD in sport.

From the *Department of Family Medicine, University of Washington, Seattle, Washington; and †Department of Cardiac, Thoracic and Vascular Sciences, University of Padova Medical School, Padua, Italy.

Submitted for publication February 12, 2010; accepted September 28, 2010.

The authors report no conflicts of interest.

Corresponding Author: Jonathan Drezner, MD, Department of Family Medicine, University of Washington, Box 354410, Seattle, WA 98195 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.