New Trials and Fibrillations post is up

It’s entitled:

More on ECG screening to prevent sudden death in the young: On risk, the Italian experience and notes from the real world.

Here’s the lead in…

Earlier this week, I wrote about one of my favorite topics in medicine: the ECG. This 12-pronged view of cardiac vectors catapulted my interest in the human heart. I love everything about ECGs. I see them as beautiful instruments for the diagnosis and treatment of heart disease. Niftier yet, ECG skills cannot be Googled; they must be gathered with mentoring and time. The story relayed in those squiggles has yet to be digitized. I like that too.

That’s why it hurts to take the view that mandating the use of screening ECGs will not completely eliminate the chance that a young person dies suddenly…

The buzz from last week’s post inspired me to go learn more.

I re-read things; studied the Italian experience, including comparing it to experiences in other countries; and then left some personal observations and even a couple of suggestions–for parents and doctors alike. I tried to write from multiple perspectives–a doctor, athlete, cross-country coach and yes, a father.

Here is the link at theHeart.org

JMM

Note: theHeart.org may require subscription. It’s free and all you have to do is provide an email.

5 comments

  1. I think it is easy for lay-persons to think that the medical field can just do a better job screening these young athletes…. I am sure we can, but there will not be a time when we can predict what someone’s rhythm will do 100% under varied circumstances.
    I have concealed LQTS along with a few other wacky rhythms going on and it was mistreated for many years for seizure disorder, then neurocardiogenic syncope, and only after several exercise stress tests did the prolonged interval come out >520-600msec. Even now it is normal on a 12 lead so many physicians will question it as an erroneous diagnosis. If I could go 26 years not knowing after countless ECGs, I am pretty sure many athletes can go undetected on a 12-lead.

      1. Dr. John- HOW COMMON is the concealed Long QT Syndrome that J.G. describes above? If this is only brought out during recovery after ETT – does it raise the same issues re baseline ECG screening – WHICH athletes should have ETT? Sorry if this opens a can of worms – but would appreciate your thoughts …

        1. It’s not common, but it’s not rare. The helpfulness of an exercise test heavily depends on the pre-test likelihood of abnormalities. Which athletes? Ah…that’s hard to say.

  2. What a great blog too. I laughed so hard at your hand surgeon post!!! You will probably see some traffic incoming from the cardiac athletes website (http://www.cardiacathletes.com/) as one of our members posted a link to your main blog.
    There are a ton of us crazy heart athletes of all abilities always looking for info and a good read on the approach to the athlete versus the traditional “doctor knows all” attitude that many of us face. We could all only dream that our cardiologist or EP was athletic AND understood our symptoms as you outline in your AFib post. Bravo!

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