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Results of a nationally implemented de novo cardiac screening programme in elite rugby players in England

Ghani, S, Papadakis, M, Kemp, S, Zaidi, A, Sheikh, N, Gati, S, Raju, H, Smith, A, Palmer, C, Somauroo, J and Sharma, S (2016) Results of a nationally implemented de novo cardiac screening programme in elite rugby players in England. British Journal of Sports Medicine, 50 (21). ISSN 0306-3674

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Abstract

Background/aim Screening of young competitive athletes remains a contentious issue. In 2010, a nationwide cardiac screening for all elite rugby players was introduced in England. This provided a unique opportunity to prospectively assess the feasibility and cost-effectiveness of a de novo, ECG-based cardiac screening programme.
Methods Between 2010 and 2012, 1191 rugby players aged ≥14 years underwent cardiac screening with a health questionnaire, 12-lead ECG and a consultation with a cardiologist. The players with concerning findings on initial evaluation were offered on-site transthoracic echocardiogram (TTE). Athletes were referred for further investigations as deemed necessary. The overall cost of the screening programme was estimated.
Results After initial evaluation, 9.7% of athletes underwent on-site TTE; 8.2% underwent on-site TTE due to ECG anomalies and 1.4% underwent on-site TTE due to concerns on the questionnaire. After TTE, only 2.9% of the total cohort was referred for further evaluation. Two players were diagnosed with potentially serious conditions; one with Wolff-Parkinson-White, who resumed competition after catheter ablation, and one with hypertrophic cardiomyopathy, who withdrew from competition. During a mean follow-up of 52.8±5.5 months, none of the players who were reassured experienced any adverse cardiac events. The total cost of the screening programme was £59 875, which averaged to a cost of £50 per player or £29 938 per condition identified. Application of refined ECG criteria would reduce the ECG false-positive rate to 4.9%.
Conclusions Preparticipation cardiac screening with 12-lead ECG is feasible. Refinement of the ECG criteria, the use of on-site TTE and expert setting can minimise the burden of unnecessary investigations and reduce costs.

Item Type: Article
Uncontrolled Keywords: 11 Medical And Health Sciences, 09 Engineering, 13 Education
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: BMJ Publishing Group
Related URLs:
Date Deposited: 09 Apr 2018 11:16
Last Modified: 09 Apr 2018 11:16
DOI or Identification number: 10.1136/bjsports-2015-095902
URI: http://researchonline.ljmu.ac.uk/id/eprint/8430

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