Pre-competition cardiac screening in professional handball players - setting up at the EHF European Handball Championship 2010 in Austria

Zusammenfassung: In vielen Sportarten wird ein regelmäßiges, richtliniengetreues kardiales Screening zur Verhinderung des plötzlichen Herztods noch immer nicht gewährleistet. Wir nahmen die Handball Europameisterschaften, welche 2010 in Wien und weiteren Städten in Österreich stattfanden, zum Anlass, die aktuelle Situation bei Toplevel-Handballern zu untersuchen: Ein standardisierter Fragebogen wurde vor dem Turnier an alle qualifizierten Teams und Spieler versandt. Eine Rücklaufrate von 42,7 % kann zum Schluss führen, dass das Problem des plötzlichen Herztods bei den Spielern und Verantwortlichen unterschätzt wird. Die überwiegende Mehrzahl der Spieler (82 %) wurde gemäß der Auswertung der Fragebögen korrekt, entsprechend der aktuellen Screening-Richtlinien untersucht. In gut der Hälfte der Teams wurde das Screening jedoch "inhomogen" durchgeführt. 5 Spieler (4,1 %) wurden zumindest nicht innerhalb der letzten Jahre untersucht, bei 1 Spieler (0,8 %) wurde kein EKG durchgeführt. Während 69 % der Handballer ihr erstes Screening erst nach dem Alter von 18 Jahren durchliefen, wurden 16 Spieler (13,1 %) gar niemals zuvor einer kardialen Vorsorgeuntersuchung unterzogen. Schließlich identifizierten wir aufgrund der Fragebögen 17 Athleten (13,9 %) mit einer hoch suspekten Anamnese, wovon 2 Athleten (1,6 %) niemals zuvor kardiologisch abgeklärt wurde

Pre-competition cardiac screening in professional handball players - setting up at the EHF European Handball Championship 2010 in Austria

In many sports, regular cardiac screening for exercise-associated sudden cardiac death is still not provided. To set up the current situation in top-skilled handball players qualified for the 2010 European Handball Championship in Austria, a standardised questionnaire was sent to every team. The fact that only 42.7% of the players returned the questionnaire may lead to the conclusion that the awareness of the problem is quite low. However, 82% of these players have been screened according to current recommendations. Half of the teams were screened inhomogeneously: 5 players (4.1%) have not been screened within the last years, 1 athlete (0.8%) was screened without an ECG. While 69% of the athletes got their first screening only after the age of 18, 16 players (13.1%) never went through a specific screening ever. We identified 17 athletes (13.9%) with a highly suspicious history, 2 of them (1.6%) never underwent a medical screening at all

Cost-effectiveness of pre-participation screening of athletes with ECG in Europe and Algeria

The aim of this study is to evaluate the costeffectiveness of ECG in combination with family and personal history and physical examination in order to detect cardiovascular diseases that might cause sudden death in athletes. The study was conducted on a cohort of 6,634, mainly young professional and recreational athletes, 1,071 from Algeria and 5,563 from Europe (France, Germany and Greece). Each athlete underwent medical history, physical examination, and resting 12-lead ECG. 293 athletes (4.4 %), 149 in Europe (2.7 %) and 144 in Algeria (13.4 %) required further tests, and 56 were diagnosed with cardiovascular disease and thus disqualified. The costeffectiveness ratio (CER) was calculated as the ratio between the cost of screening and the number of statistical life-years saved by the intervention. The estimated reduced risk of death deriving from treatment or disqualification resulted in the saving of 79.1 statistical life-years in Europe and 136.3 in Algeria. CER of screening was 4,071 purchasing- power-parity-adjusted US dollars ($PPP) in Europe and 582$PPP in Algeria. The results of this study strongly support the utilisation of 12-lead ECG in the preparticipation screening of young athletes, especially in countries where secondary preventive care is not highly developed