THE PREVENTION OF SUDDEN CARDIAC DEATH IN ATHLETES: CARDIOVASCULAR SCREENING PRACTICES IN UNITED STATES NATIONAL GOVERNING BODIES AND PARALYMPIC COMMITTEES

Background Cardiac screening in athletes has recently been a focus of investigation and debate among the sports medicine community. Athletic associations and organizations, including the International Olympic Committee, have issued recommendations regarding screening practices in an effort to prevent sudden cardiac death in sport. Objective To examine cardiovascular screening strategies among Olympic-level athletic teams. Design Cross-sectional survey. Setting United States National Governing Bodies (NGBs) and National Paralympic Committees (NPCs). Participants Medical team members for US NGBs and NPCs. Interventions Medical team members were surveyed regarding the cardiovascular screening practices of their respective teams. Main Outcome Measurements The screening components and screening frequency performed by US NGBs and NPCs. Results Medical team members for 49/72 (68%) of the US NGBs and NPCs were identified and contact information was obtained through various sources. 42/49 teams (86%) completed the assessment (34 from NGBs and 8 from NPCs). Twenty-one of 42 teams (50%) reported that there was a periodic health evaluation requirement that directed the cardiovascular screening components, frequency, and/or provider. The following screening components were reported as being performed at least once in all or most athletes: personal history (91% of teams), family history (86%), physical exam (81%), electrocardiogram (33%), echocardiogram (5%), and stress test (2%). For teams who did not screen athletes with ECG, the most frequently cited reasons were lack of ECG equipment (40%), lack of evidence (33%), and lack of consensus regarding follow-up testing (20%). Conclusion The US NGBs and NPCs are a heterogeneous collection of athletic teams that have varying approaches to cardiovascular screening. Lack of infrastructure appears to be the biggest barrier to implementing advanced screening protocols. Results from this investigation can be used to support efforts to provide consistent cardiovascular screening practices to NGB and NPC athletes with the goal of preventing tragedy from sudden cardiac death.