Mandatory Electrocardiographic Screening of Athletes to Reduce Their Risk for Sudden Death Proven Fact or Wishful Thinking?
Mandatory Electrocardiographic Screening of Athletes to Reduce Their Risk for Sudden Death Proven Fact or Wishful Thinking?
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DOI：
10.1016/j.jacc.2010.10.037
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发表时间：
2011-03-15
影响因子：
24
通讯作者：
Viskin, Sami
中科院分区：
文献类型：
--
作者：
Steinvil, Arie;Chundadze, Tamar;Viskin, Sami
目的 本研究的目的是确定通过静息和运动心电图 (ECG) 等策略对运动员进行赛前筛查是否可以降低猝死风险。 背景 越来越多的国家强制要求对运动员进行赛前心电图筛查，以预防猝死。然而，表明这种策略实际上可以降低运动员猝死风险的证据有限。因此，我们分析了以色列 1997 年颁布的国家体育法（该法要求对所有运动员进行静息心电图和运动测试筛查）对竞技运动员猝死发生率的影响。方法我们对以色列两家主要报纸进行了系统搜索，以确定竞技运动员每年发生心脏骤停事件的数量。处于危险中的人口规模是从以色列体育局检索的，并推断出人口规模随时间的变化。结果 1985 年至 2009 年期间，记录在案的竞技运动员中发生了 24 起猝死或心脏骤停事件。其中 11 起发生在 1997 年立法之前，13 起发生在 1997 年立法之后。猝死或心脏骤停事件的平均年发生率为每 100,000 名运动员年 2.6 起。 1997 年立法之前十年和之后十年的平均年发病率分别为每 10 万人年 2.54 起和 2.66 起事件（p = 0.88）。 结论 我们研究中运动员猝死的发生率在其他人报道的范围内。然而，对运动员进行强制性心电图筛查对他们的心脏骤停风险没有明显影响。 （J Am Coll Cardiol 2011；57:1291-6）(C) 2011 年，美国心脏病学会基金会
Objectives The purpose of this study was to determine if pre-participation screening of athletes with a strategy including resting and exercise electrocardiography (ECG) reduces their risk for sudden death.Background An increasing number of countries mandate pre-participation ECG screening of athletes for the prevention of sudden death. However, the evidence showing that such a strategy actually reduces the risk of sudden death in athletes is limited. We therefore analyzed the impact of the National Sport Law enacted in Israel in 1997-which mandates screening of all athletes with resting ECG and exercise testing-on the incidence of sudden death among competitive athletes.Methods We conducted a systematic search of the 2 main newspapers in Israel to determine the yearly number of cardiac arrest events among competitive athletes. The size of the population at risk was retrieved from the Israel Sport Authority and was extrapolated to the changes in population size over time.Results There were 24 documented events of sudden death or cardiac arrest events among competitive athletes during the years 1985 through 2009. Eleven occurred before the 1997 legislation and 13 occurred after it. The average yearly incidence of sudden death or cardiac arrest events was 2.6 events per 100,000 athlete-years. The respective averaged yearly incidence during the decade before and the decade after the 1997 legislation was 2.54 and 2.66 events per 100,000 person years, respectively (p = 0.88).Conclusions The incidence of sudden death of athletes in our study is within the range reported by others. However, mandatory ECG screening of athletes had no apparent effect on their risk for cardiac arrest. (J Am Coll Cardiol 2011; 57:1291-6) (C) 2011 by the American College of Cardiology Foundation