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ECG screening of young athletes for risk of sudden cardiac death is growing in popularity throughout the world. Research in Italy has demonstrated its efficacy in identifying previously unrecognized life threatening cardiac conditions. Controversy remains regarding the feasibility and cost of such screenings in the United States. Our YH4L® (Young Hearts for Life) ECG screening program has addressed these issues by training community volunteers to quickly and efficiently perform a 12–lead ECG during screening exams. However, criticism persists surrounding the accuracy of the ECGs performed by community volunteers. We sought to provide evidence that the technical error rate of our community volunteers is no higher than that of trained ECG technicians.
Community volunteers were trained via a standardized, proprietary 90 min. informational session on how to perform a 12–lead ECG. During the screening, the volunteers were supervised by experienced staff (average ratio of 1supervisor to 12 volunteers). All ECGs performed during the screening were monitored for technical inadequacies. Two cardiologists over reading the screening ECGs identified tracings that were deemed technically inadequate. The rate of technical error by the community volunteers was compared to published rates of technical error by trained ECG technicians.
A total of 4,477 ECGs performed by the community volunteers on 5 consecutive screening days were analyzed for this study. 15 tracings were deemed technically inadequate. Technical errors included limb lead reversals and misplaced precordial leads. The rate of technical error for the community volunteers was 0.34% in the screening setting. This was lower than the published 0.4% technical error rate of ECGs performed in outpatient clinics by trained technicians.
The rate of technical error by community volunteers trained to perform screening ECGs is comparable to that of trained ECG technicians. ECGs can be performed by properly trained and supervised community volunteers with an acceptable technical error rate allowing large scale ECG screening to be performed efficiently and at low cost.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Sports and Exercise Cardiology: Improving the Accuracy of Screening
Abstract Category: 29. Sports and Exercise Cardiology: Diagnostic Testing: ECG Exercise or “The Older Athlete”
Presentation Number: 1131–258
- 2013 American College of Cardiology Foundation