New training package could help doctors cut rates of sudden cardiac death in athletes

Progress on curbing the leading killer of athletes―sudden cardiac death―by spotting heart problems early, has been slow. But the development of a series of online tutorials for sports and cardiology doctors looks set to reverse this trend.
 
The tutorials, which are free to any doctor around the globe, thanks to the backing of the American Medical Society for Sports Medicine (AMSSM) and FIFA, aim to teach physicians how to read heart monitor tracings (ECGs) and spot abnormalities linked to potentially fatal disorders.
 
Some inborn heart conditions are difficult to detect, because they progress silently, and are only diagnosed when intense exercise triggers a lethal heart rhythm―sudden cardiac arrest. According to the American Heart Association, over 7,000 people under the age of 18 die every year in the US of a sudden cardiac arrest. Studies also suggest the risk is three times higher in competitive athletes.
 
Last year in the UK, soccer player Fabrice Muamba collapsed on the pitch following a sudden cardiac arrest at the age of 24. He received prompt expert medical attention which helped him make a remarkable recovery. 
 
But many athletes are not as lucky, and trying to pick up those most at risk is the only way of warding off sudden cardiac arrest, which could be―and often is―deadly. And interpreting ECGs in athletes can be difficult, because their hearts have adapted to the stress of extensive training and top level performance.
 
Initiated by AMSSM President, Jonathan Drezner, MD, in association with BMJ Learning and the British Journal of Sports Medicine, and developed and written by international experts in sports medicine and sports cardiology, the training modules guide doctors on how to recognize ECG changes that indicate problems rather than healthy cardiac adaptation. 
 
The online course, which can be found at: http://learning.bmj.com/ECGathlete, includes five tutorials:

• ECG interpretation in athletes: identify your learning needs 
• Normal ECG findings: recognizing physiologic adaptations in athletes
• Abnormal ECG findings in athletes: recognizing changes suggestive of cardiomyopathy
• Abnormal ECG findings in athletes: recognizing changes suggestive of primary electrical disease 
• ECG interpretation in athletes: test your knowledge 
 
 “Whether used for diagnostic or screening purposes, ECG interpretation is a fundamental skill for doctors involved in the cardiovascular care of athletes,” comments Dr. Drezner. 
 
He adds “These online learning modules provide doctors with a common basis for interpreting an athlete’s ECG, boosting their chances of making an accurate diagnosis, and of picking up potentially life-threatening problems earlier.” 
 
The modules draw on a series of papers presenting new consensus standards on ECG interpretation in athletes, published in the British Journal of Sports Medicine.*
 
The standards were developed in collaboration with AMSSM, the Section on Sports Cardiology of the European Association for Cardiovascular Prevention and Rehabilitation (EACPR), a registered branch of the European Society of Cardiology (ESC), the FIFA Medical Assessment and Research Center (F-MARC), and the Pediatric & Congenital Electrophysiology Society (PACES).
 
“The consensus standards on ECG will help doctors taking care of athletes in every sport to ward off sudden cardiac death,” comments Professor Jiri Dvorak, FIFA Chief Medical Officer.
 
“Ten years ago Marc-Vivian Foe died on the pitch during the FIFA Confederation Cup in Lyon as a result of sudden cardiac death. This shocking event prompted us to take action. A medical assessment before a match, which includes an ECG, is now mandatory for all players taking part in FIFA competitive events,” he adds.
 
As part of its ongoing commitment to ensuring competitor safety, FIFA has also created a standard emergency bag for sports doctors, which comes equipped with a portable defibrillator (AED), which can be used to diagnose and treat cardiac arrhythmias on the pitch, he says.
 
These will be distributed in June 2013 to all 209 national member associations of FIFA.
 
 Notes for editors:
 *Linked papers:
 
 Electrocardiographic Interpretation in Athletes: the "Seattle Criteria"  .Drezner JA, Ackerman MJ, Anderson J, et al. Br J Sports Med. 2013;47:122-124.doi:10.1136/bjsports-2012-092067 
 
 Normalelectrocardiographic findings: recognizing physiological adaptations in athletes  . Drezner JA, FischbachP, Froelicher V, et al. Br J Sports Med: 2013 Feb; 47(3):125-36 doi:10.1136/bjsports-2012-092068 

 Abnormalelectrocardiographic findings in athletes: recognizing changes suggestive of cardiomyopathy  . Drezner JA,Ashley E, Baggish AL, et al. Br J Sports Med : 2013 Feb;47(3):137-152doi:10.1136/bjsports-2012-092069 
 
 Abnormalelectrocardiographic findings in athletes: recognizing changes suggestive of primary electrical disease  .Drezner JA, Ackerman MJ, Cannon BC, et al. Br J Sports Med : 2013Feb;47(3):153-167 doi:10.1136/bjsports-2012-092070 
 
The British Journal of Sports Medicine is one of more than 40 specialist titles published by BMJ Group.   www.bjsm.bmj.com

About the AMSSM
The AMSSM is a multi-disciplinary organization of sports medicine physicians whose members are dedicated to education, research, advocacy, and the care of athletes of all ages. Founded in 1991, the AMSSM is now comprised of more than 2,300 sports medicine physicians whose goal is to provide a link between the rapidly expanding core of knowledge related to sports medicine and its application to patients in a clinical setting. www.amssm.org
 
About BMJ Learning
BMJ Learning offers high-quality continuing medical education for doctors and other healthcare professionals. It features hundreds of accredited, peer-reviewed learning modules in text, video, and audio formats. www.learning.bmj.com