Aims

Sudden cardiac death (SCD) in young individuals is often unexpected, provoking substantial emotional stress for family and friends of the deceased. Cardiac screening may identify individuals who harbour disorders linked to SCD. The feasibility and diagnostic yield of a nationwide cardiac screening program in adolescents has never been explored.

Methods

All individuals eligible for cardiac screening (15-year old students) were systematically invited to enrol. Students were provided with a health questionnaire. ECGs were acquired at school. A physician led consultation was carried out on site. Participants with an abnormal screen were then referred for secondary evaluation to the nation’s tertiary centre. Feasibility criteria included a) participation rate >60%, b) adherence to secondary evaluation >80% and c) cost per individual screened equating to <€100. The diagnostic yield was also evaluated.

Results

At the end of enrolment, 2708 students gave consent (mean 15 years, 50.4% male), equating to 67.9% of the eligible cohort. 109 participant (4.0%) were referred for further evaluation. An abnormal ECG was the commonest reason for referral (3.7%). Fifteen individuals (0.6%) were diagnosed with a cardiac condition. Nine (0.3%) had a condition linked to SCD (n=1 LQTS, n=1 HCM, n=5 WPW, n=2 coronary anomalies). The yield was similar in athletes and non-athletes (p=0.324). The cost per cardiac individual screened equated to €51.15.

Conclusion

A nationwide systematic cardiac screening program for adolescent athletes and non-athletes is feasible and cost-efficient, provided that responsible centres have the appropriate infrastructure.

中文翻译：

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BEAT-IT：马耳他青少年的从头心脏筛查计划

目标

年轻人的心源性猝死 (SCD) 通常是意外的，会给死者的家人和朋友带来巨大的情绪压力。心脏筛查可以识别患有与 SCD 相关疾病的个体。全国青少年心脏筛查计划的可行性和诊断率从未被探索过。

方法

所有符合心脏筛查资格的个人（15 岁学生）均被系统邀请参加。向学生提供了一份健康调查问卷。心电图是在学校获得的。医生现场进行了会诊。然后，筛查异常的参与者被转介到国家三级中心进行二次评估。可行性标准包括 a) 参与率 >60%，b) 二次评估遵守率 >80%，以及 c) 每人筛查成本低于 100 欧元。还评估了诊断率。

结果

注册结束时，有 2708 名学生表示同意（平均年龄 15 岁，男性占 50.4%），相当于合格群体的 67.9%。109 名参与者 (4.0%) 被转介进行进一步评估。心电图异常是转诊的最常见原因 (3.7%)。15 人 (0.6%) 被诊断患有心脏病。9 例 (0.3%) 患有与 SCD 相关的病症（n=1 例 LQTS、n=1 例 HCM、n=5 例 WPW、n=2 例冠状动脉异常）。运动员和非运动员的产量相似 (p=0.324)。每个心脏病患者的筛查费用为 51.15 欧元。

结论

只要负责的中心拥有适当的基础设施，针对青少年运动员和非运动员的全国性系统性心脏筛查计划是可行且具有成本效益的。