Prevention of Sudden Cardiac Death in Non-Competitive Athletes: ECG Screening by Telecardiology Is Useful and Cost-Effective

Abstract

<i>Background: </i>Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. There are several hereditary, structural, or electrical heart diseases associated with SCD, most of them can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). <i>Objective: </i>To evaluate usefulness and cost-effectiveness of ECG screening, using a telecardiology system, in order to detect cardiovascular diseases that might cause SCD in a cohort of non-competitive athletes (NCA). <i>Methods: </i>ECGs received at the Telecardiology Center (Telemedico Srl, Genoa) for non-competitive sports, in a 3-month period were analyzed. According to the age we distinguished: NCA < 35 years (group A) and NCA > 35 years (group B). <i>Results: </i>A total of 6345 NCA (4078 males, 64.2%) were evaluated between the ages of 5 and 50 years (mean ± SD: 28.4 ± 12.6). Group A (age < 35 years) consisted of 3453 (54.4%) NCA and group B (age > 35 years) of 2892 (45.6%) respectively. An ECG pattern at risk of SCD has been identified in 295 (4.6%) subjects. Prevalence of ECG abnormalities was higher for group B (154/2892; 5.3%) than group A (141/3453; 4.1%); the difference was significant (p= 0.016). The average cost per ECG was € 12. The cost of ECG screening to identify a risk situation of SCD was € 258. <i>Conclusion: </i>ECG screening through telecardiology of NCA results to be feasible, useful and cost-effective.