The new A.H.A. scientific statement about the 12-lead ECG as a screening tool for youth and young adults

The American Heart Association recently published an excellent document that very comprehensively examines the  12-lead electrocardiogram (ECG) as a tool to screen populations of youth and young adults (age range 12-25).

This will be a very useful reference document for years to come.  It covers medical, technical, logistical, socioeconomic, legal, and ethical aspects of screening in great detail, and lists a vast number of references.

The final recommendation against endorsing the use of the ECG for “mandatory and universal mass screening” is unsurprising, and was anticipated by most attendees of the recent Sports and Exercise Cardiology Summit.

We agree with this recommendation, inasmuch as mandatory mass screening of the entire population in that age group (~ 60 million individuals) would be not only impractical, but could overwhelm the health care system.  There is simply not enough manpower to do the job properly, and the problem is compounded by the inherent problem of “false positive” and “false negative” effects that occur when the ECG is used as a stand-alone test.

It is noteworthy that the American Heart Association—in this, as well as in previous documents—strongly endorses screening efforts that emanate from medical practices and local communities, where many of the inherent limitations of mass screening can reasonably be overcome.

This comprehensive review of all the important factors pertinent to screening reinforce our belief that the screening strategy adopted by AHSF—using multiple tools and with hands-on attention by trained personnel—is the best available strategy to correctly identify or exclude cardiac problems before complications occur.