P2A165: Survey on Screening for Conditions Associated with Sudden Cardiac Death

Background: Sudden cardiac death (SCD) in children and adolescents is rare but receives considerable attention due to its tragic nature. Although SCD is an important clinical issue, there is little data for decision-making regarding pre-participation screening in young competitive athletes and non-athletes.

Methods: We sent an anonymous electronic survey to the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery (AAP SOCCS) and the Pediheart.net online community regarding pediatric cardiovascular providers’ opinions and practices on the screening of youth for conditions associated with SCD. Responses from pediatric electrophysiologists were compared to all other respondents.

Results: In total, 135 respondents completed the survey, of which 15 were pediatric electrophysiologists and 120 were other members of the pediatric cardiology community. Respondents generally thought the emphasis on screening was appropriate as shown in Table 1. 16% of respondents were at least moderately concerned about the liability associated with reading screening ECGs, and 4% of those respondents were extremely concerned (Table 1).

In general, respondents did not want to alter screening based on race and ethnicity (89%) or gender (93%). Overall, 44% of respondents believe that pre-participation screening for conditions associated with SCD should be different for competitive athletes compared to non-competitive athletes (Table 2). With regard to screening high school-age individuals, 42% of respondents recommended ECGs for competitive athletes, and 21% recommended ECGs for those who are not identified as competitive athletes (Table 2). Echocardiography was recommended for competitive athletes by 9% of respondents, but none recommended echocardiographic screening for those who are not identified as competitive athletes.

There was no statistically significant difference between the 15 pediatric electrophysiologists and the other members of the pediatric cardiology community.

Conclusion: Our data does not demonstrate a consensus on the role of ECG in pre-participation screening. Respondents thought that screening for conditions associated with SCD should not be altered based on gender or race, but an important minority felt someone's status as a competitive athlete should influence screening. A minority of respondents recommended ECG screening for both youth identified as competitive athletes and those not identified as competitive athletes.