Abstract 17198: The Prevalence of ECG Anomalies in Young Individuals: Relevance to a Nationwide Cardiac Screening Program

Abstract

Objectives: This study aims to investigate the prevalence of Group 1 and Group 2 ECG abnormalities in young individuals and assess the potential impact of a nationwide screening program for conditions predisposing to sudden cardiac death (SCD) in the young, irrespective of athletic activity. Background: Data from the 30-year Italian experience suggest that pre-participation cardiac screening (PPS) utilising the 12-lead ECG can reduce the incidence SCD in competitive athletes. However, the majority of SCD in the young occur in the non-athletic population. In the UK, screening for sinister cardiac disorders in the general population is confined to individuals with symptoms or family history of inherited cardiac conditions or premature cardiac death.

Methods: Between 2008 and 2012, 7764 consecutive non-athletic individuals (70.2% male, 93.8% Caucasian) aged 14-35 years underwent evaluation with a 12-lead ECG. ECGs were analysed for specific abnormalities as described in the 2010 European Society of Cardiology position paper, which advocates further cardiovascular evaluation for individuals with Group 2 ECG abnormalities.

Results were compared with 4081 athletes (80.5% male, 69.1% Caucasian) of similar age. Results: Group 1 abnormalities were present in 49.1% of non-athletes and 87.4% of athletes (p<0.001). Group 2 abnormalities occurred in 21.8% of non-athletes and 33.0% of athletes (p<0.001). In the general non-athletic population, male gender (OR 2.88; 95%CI 2.32 to 3.59, <0.001) and black ethnicity (OR 2.39; 95%CI 1.35 to 4.24, p=0.003) demonstrated the strongest association with Group 2 ECG changes.

Conclusions: The study demonstrates a high prevalence of ECG abnormalities when applying the ESC consensus criteria to young non-athletic individuals. Many of these abnormalities are non-specific in isolation and may warrant further investigations to confirm cardiac disease. Such a high burden of ECG abnormalities has significant implications on the feasibility and cost-effectiveness of a nationwide cardiac screening program in young individuals based on current consensus guidelines.