New screening research published

18th November 2017

New research shows that screening young athletes for cardiac conditions will not predict if they are at risk of cardiac arrest.

The findings published in the New England Journal of Medicine looked at every instance of cardiac arrest that occurred from 2009 through 2014 in people age 12 to 45 among 6.6 million residents in the southern Ontario area. The research found that sudden cardiac death during participation in competitive sports is rare, the causes are varied, and over 80 percent of cases would not be caught through screening examinations.

Dr Paul Dorian at the University of Toronto who led the research said the biggest problem with screening programs is that they raise a false alarm in too many amateur athletes.
“Screening athletes is likely to cause more harm than benefit,” he said. “It’s the worry, concern, fright - which is mostly unnecessary - that these young individuals and families have to undergo when they’re identified as maybe having a problem while they’re waiting for test results.”

“And even if a problem comes up, in fact, the risk would likely be very, very small,” said Dr. Dorian. “For the majority of people, the benefits of participating in competitive sports far outweigh any risk of sudden cardiac arrest.”

The study found over the course of the 6-year study period there were 74 sport-related cardiac arrests. Only 16 of the 74 occurred during or within an hour of playing a competitive sport; the rest were among people involved in a non-competitive sport, where no formal league was involved.

Only 3 of those 16 cases “were determined to have been potentially identifiable if the athletes had undergone participation screening,” said the researchers. They identified two of these cases were found to have hypertrophic cardiomyopathy (HCM) which often runs in families.

Dr. Dorian and his team calculated that the odds of an athlete developing a sudden arrest during competition or training were 1 in 131,600 per year, with 44% surviving to be discharged from the hospital. To put that in perspective, the odds of a sudden cardiac arrest among the general population age 12 to 45 is about 6 times higher - or 1 in 20,700 per year.

Cardiac arrest occurs when the heart stops beating normally. Without emergency treatment, cardiac arrest is fatal within minutes.

Joel Rose, Chief Executive, Cardiomyopathy UK said “This study confirms our position that we need to continue to work harder to educate clinicians and the general public about the importance of identifying people who are at risk so that they can be screened appropriately, and offered targeted genetic testing which we feel is a more effective use of NHS resources than an untargeted cardiovascular screening programme for all young people.”

You can find out more about our screening position here