Comparison of U.S. and Italian Experiences With Sudden Cardiac Deaths in Young Competitive Athletes and Implications for Preparticipation Screening Strategies

Pre-participation assessment in young athletes: a state affair

“…By comparing the Italian experience with other countries such as US [11][12][13] and European countries where the 12-lead ECG is compulsory to obtain eligibility, it is reasonable to think that the Italian PPE program is probably impractical as it would require considerable resources that are currently not available. The Italian experience itself [14][15][16] has demonstrated that the application over the last 30 years in the Veneto region of the ECG screening has determined an 89 % absolute risk decrease of sudden cardiac death in competitive athletes, while the association of 12-lead ECG plus cardiovascular-focused history and physical examination may produce more additional benefits with a reasonable cost-effective ratio [17].…”

“…This issue is now more relevant, considering a large and recently increasing cohort of overweight subjects among the competitive athletes. Any restriction from participation must be made based on the best medical objective evidence [13], and should be determined by keeping the cardiac and aerobic demands of the proposed activity in mind. An understanding of the strenuousness activity in relation to the sport practiced, and to its physical limitations, is crucial.…”

Pre-participation screening for the prevention of sudden cardiac death in athletes

“…Smaller studies, performed as population based investigations, reported, also in the United States, an incidence of either SCD of young individuals and athletes similar to that reported by Shen et al [17] in Italy. Similarly, Maron et al [18] in 2009 reported an annual incidence of SCD among United States high-school and college athletes roughly similar to that observed in Italy.…”

Economic Evaluation of Strategies to Reduce Sudden Cardiac Death in Young Athletes

“…The annual incidence of SCD in athletes is estimated from 1 to 6 per 100 000 persons. [1][2][3] The most common conditions that increase SCD risk include hypertrophic cardiomyopathy (HCM), coronary artery anomalies of wrong sinus origin, arrhythmogenic right ventricular cardiomyopathy, and various arrhythmia syndromes. [4][5][6] These diagnoses are typically undetected before SCD.…”