Intended for healthcare professionals


Sudden cardiac death in young athletes

BMJ 2008; 337 doi: (Published 03 July 2008) Cite this as: BMJ 2008;337:a309

Detect risk with Automate Exercise ECG

The evidence shows that resting ECG fails on both essential criteria
for a screening test, high specificity and high sensitivity, in that
order. Low specificity inevitably generates unnecessary worry and expense.

It is not unreasonable to assume that an exercise ECG satisfies both
criteria so far as the target abnormality, induced exercise-induced
cardiac arrhythmia, is concerned. An an initially blinded automated system
similar to that used in defibrillators provides the solution. The system
would allow the test to proceed unless the resting trace showed a clearly
dangerous resting abnormality and stop the test if one developed. Although
no trace would show the memory would retain it for necessary refence.
Required training would be little more than that necessary to understand
and operate the accompanying defibrillator. If this practice became
prevalent the cost would fall rapidly particularly if the accompanying
treadmill was dual purpose being available for general use at other times.

Competing interests:
None declared

Competing interests: No competing interests

18 July 2008
C. Kevin Connolly
Retired Respiratory Physician
Richmond DL117TP