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Can electrocardiographic screening prevent sudden death in athletes? Yes

BMJ 2010; 341 doi: (Published 14 September 2010) Cite this as: BMJ 2010;341:c4923
  1. Antonio Pelliccia, scientific director1,
  2. Domenico Corrado, associate professor2
  1. 1Institute of Sports Medicine and Science, Italian National Olympic Committee, Largo Piero Gabrielli, 1 00197 Rome, Italy
  2. 2Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
  1. Correspondence to: A Pelliccia ant.pelliccia{at}

    Mandatory electrocardiographic screening of athletes would detect heart problems and save lives, argue Antonio Pelliccia and Domenico Corrado, but Roald Bahr (doi:10.1136/bmj.c4914) claims that the diagnostic accuracy is questionable

    The European Society of Cardiology has supported electrocardiography based screening for competitive athletes since 2005, and the International Olympic Committee endorsed a similar approach in a policy statement in 2009.1 2 These position statements have raised interest in the scientific community and general public, and fuelled the current debate regarding the efficacy of pre-participation electrocardiographic screening to detect the risk of cardiovascular diseases in young athletes and to reduce deaths.

    Effect of screening on mortality

    Scientific data supporting the efficacy of electrocardiography derives from Italy, the only country where pre-participation screening is required by law and where a mass screening programme with electrocardiography has been in place for almost 30 years. This population based and long term programme has provided evidence of the efficacy of screening in identifying athletes with clinically silent cardiomyopathies, primarily hypertrophic cardiomyopathy.3 4 5

    The …

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