Electrocardiographic screening of all infants, children, and teenagers should be performed

Abstract

We should categorically strive to find the best methods to prevent SCD in the United States. The current system of screening only athletes has not achieved the goal of decreasing SCD in youth. A good first step is the recent effort by the National Institutes of Health in partnership with the US Centers for Disease Control and Prevention to fund a small number of states in a pilot project to collect information on sudden deaths, including cardiovascular deaths to develop a national registry of these deaths as recommended by the National Heart, Lung, and Blood Institute Working Group on SCD. Support of screening efforts with sound scientific rigor should be developed to determine the best methods to identify young children before they experience a SCA or SCD and intervene to prevent such occurrences. Current screening efforts should be directed at collecting data in a systematic fashion with standardized criteria for the screening process, including improving ECG test characteristics and reading skills. Screened individuals, whether positive or negative, should be tracked. Screening efforts that focus on quantity, not quality, regardless of the screening methodology used, do not advance the field. Improvement of the use of the H&P will only advance screening that adds an ECG to that process. The 2 sides of this debate should be working together and reframe this debate to reach their common goal of decreasing death in the young. We should perform ECG screening on all neonates and children in a large-scale scientific study to determine the best methodology to identify those at risk for SCD. The downstream effects of all screening for SCD conditions should be carefully investigated and adverse effects prevented. Only with that type of concerted effort will we have sufficient data to determine the best ways to screen, and on whom, by using best practices. What should be done does not mean it can be mandated at this time or that all the resources are currently available, but these recommendations should be considered from the same perspective that has driven major discoveries or solutions in other aspects of medicine and society. © 2014 American Heart Association, Inc.