Study: Pediatric Cardiologists’ Review of ECG Results in Young Athletes May Not Be Accurate

Study: Pediatric Cardiologists' Review of ECG Results in Young Athletes May Not Be AccurateIn a recent study performed in cooperation by the Stanford University School of Medicine and the Lucile Packard Children's Hospital, researchers found that pediatric cardiologists have a tendency to misinterpret electrocardiograms (ECGs) when the results are used to determine if a young athlete has a heart defect that could make strenuous activity perilous.

The study rose out of concern for the measures currently in place that are used to prevent sudden cardiac deaths among young athletes. On average, there are 76 deaths in young athletes each year caused by sudden heart problems, a statistic which prompted some to suggest athletes should receive mandatory ECG tests.

But the authors of the study found that simply studying an ECG may not be effective in preventing sudden deaths.

"An ECG doesn't always pick up the abnormalities that may predispose someone to sudden cardiac death," Dr. Allison Hill, the study's first author, said in the report. "And this exam can be difficult to interpret, even if the person reading the scan is a pediatric cardiologist."

In the study, 53 pediatric cardiologists were asked to review and interpret 18 ECG exams that were taken of healthy athletes and those with heart defects. The doctors, who had experience ranging from five to 15 years in the field, properly diagnosed the patients with heart conditions only 67 percent of the time.

Because the heart of a physically fit person tends to be relatively larger and beats slower, it may seem similar to a defective heart that would be vulnerable to sudden cardiac death, leading to young, healthy people being kept from playing sports.

Conversely, the study reveals that athletes who are predisposed to sudden heart death may be seen as healthy, and cleared to take part in strenuous activity.

"We need to be careful about giving a false sense of security to families, parents or an entire community if we have an ECG that's normal," Hill said. "It's important to know that it's not a perfect test."

Hill and her colleagues warn that if the U.S. institutes screening programs, steps should be taken to ensure that doctors are appropriately trained in reading ECGs, and understand how to incorporate them into the loads of other information pediatric cardiologists learn in training.

According to LabMate, the previously held idea that sudden cardiac death occurs at a rate of about one in 200,000 has been adjusted to roughly one in 45,000 young athletes.