Screening Teens' Hearts Could Be Lifesaving

Researcher calls ECG test a 'no-brainer' for athletes but sees benefits for all

By Steven Reinberg
HealthDay Reporter

THURSDAY, April 5 (HealthDay News) -- Checking the hearts of teenagers, athletes and non-athletes alike, could save thousands of lives, a new study suggests.

The heart check recommended is an electrocardiogram (ECG), which records the electrical activity in the heart and identifies those at risk for sudden cardiac arrest.

"I think we should do this testing and find the kids who are at risk for sudden death and potentially save their lives," said the study's lead researcher, Dr. Joseph Marek, founder and medical director of the Midwest Heart Foundation in Oakbrook Terrace, Ill.

ECGs are especially important for teens who are going to take part in sports, he said.

"To me as a parent, this is a no-brainer," Marek said. "I think doctors should be recommending ECGs to their teen patients."

Not everyone agrees, however. One of the main objections to doing extensive ECG testing has been cost, but Marek said the tests in his study cost less than $10 each. For the study, his team raised money for the testing through community donations.

Marek said that some also feared that testing teens would swamp the medical system because the rate of abnormal heart rhythms among young adults was thought to be in the 10 percent to 40 percent range. But, he said, "our study shows that number is well under 3 percent," so that idea "doesn't hold water."

"ECG testing of young adults is certainly feasible," he said.

Each year in the United States, more than 250,000 people die from sudden cardiac arrest, including an estimated 2,000 young adults, according to the study.

But, according to Marek, "sudden cardiac death in young adults can be identified before they have a catastrophe in a cost-effective manner by doing ECG testing."

For an ECG test, small patches called electrodes are put on the skin in several places on the body and attached by wires to a machine that will print out wavy lines that indicate the heart's electrical activity, according to the U.S. National Library of Medicine. The person lies very still for the test, which usually takes only a few minutes.

Between 2006 and 2010, Marek's research team gave ECGs to 50,665 teens, 14 to 18 years old, including athletes and non-athletes. The screening was done in 32 schools in suburban Chicago during the regular school day.

Screening identified 1,096 teens with abnormal ECGs, indicating a heart irregularity that could result in sudden cardiac death. Of those teens, 150 were found to have left ventricular hypertrophy, which can lead to hypertrophic cardiomyopathy, the most common cause of sudden cardiac death. Another 145 had a condition called prolonged QTc, which could indicate long QT syndrome, also linked to sudden cardiac death.

The findings were to be presented Thursday in San Francisco at the Heart Rhythm Society's annual scientific sessions. Experts note that research presented at meetings should be considered preliminary because it has not been subjected to the rigorous scrutiny given to research published in medical journals.

A similar study done in Italy over a 26-year period found that ECG screening cut the number of cardiac deaths by 89 percent, Marek said.

Dr. Gregg Fonarow, the associate chief of cardiology at the University of California, Los Angeles, medical school said that "sudden cardiac death in the young can have devastating impact on families, care providers and the community."

Though some of the abnormalities that cause these deaths can be detected by screening ECGs, Fonarow said, "the routine use of screening ECGs in the young is controversial."

"Further studies of ECG screening are needed to evaluate the resource requirements, reliability, reproducibility, effectiveness of preventing sudden cardiac arrest and potential harmful effects of screening," he said.

More information

The U.S. National Heart, Lung, and Blood Institute has more on sudden cardiac arrest.

SOURCES: Joseph Marek, M.D., medical director, Midwest Heart Foundation, Oakbrook Terrace, Ill.; Gregg Fonarow, M.D., associate chief, cardiology, David Geffen School of Medicine, University of California, Los Angeles; May 5, 2011, presentation, Heart Rhythm Society, 32nd Annual Scientific Sessions, San Francisco

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