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A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening

Published online by Cambridge University Press:  10 October 2016

Angira Patel ,
Gregory Webster ,
Kendra Ward  and
John Lantos
Angira Patel*
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Gregory Webster
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
Kendra Ward
Affiliation:
Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
John Lantos
Affiliation:
Children’s Mercy Bioethics Center, Kansas City, Missouri, United States of America
*
Correspondence to: A. Patel, MD, MPH, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue, Box 21, Chicago, IL 60611, United States of America. Tel: +312 227 4100; Fax: +312 227 9640; E-mail: anpatel@luriechildrens.org
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Abstract

Aim

The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE).

Methods

Paediatricians affiliated with a tertiary children’s hospital completed a survey about ECGs for PPSE.

Results

In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die. Only 16% of paediatricians perform all 12 American Heart Association recommended elements of the PPSE. If any of these screening elements are abnormal, 69% obtain an ECG, 36% an echocardiogram, and 30% restrict patients from sports activity; 73% of them refer the patient to a cardiologist.

Conclusion

Most of the general paediatricians surveyed did not currently perform ECGs for PPSE. In addition, there was a low rate of adherence to performing the 12 screening elements recommended by the American Heart Association. They have trouble obtaining timely, accurate ECG interpretations, worry about potential unnecessary exercise restrictions, and cost-effectiveness. The practical hurdles to ECG implementation emphasise the need for a fresh look at PPSE, and not just ECG screening. Improvements in ECG performance/interpretation would be necessary for ECGs to be a useful part of PPSE.

Keywords

Electrocardiogramscreeningsurveypaediatrician
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 884 - 889
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Copyright
© Cambridge University Press 2016 

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