Athletic Screening

In 2007 we began performing ECGs as part of the pre-participation exam (PPE) for all Stanford athletes, in which athletes provided consent under Stanford IRB approval. The ECGs were digitized and entered into a database leading to three papers, the first reporting our experience with screening (Le, 2008) and then two others looking at the effect of gender (Mandic, 2009) and specific sport (Gademon, 2011) on the computerized measurements. We published a CPC monograph entitled, "Adding the ECG to the PPE" (Perez, 2009) and to justify adding the ECG, we performed a cost-efficacy analysis published in the Annals of Internal Medicine (Wheeler, 2009). The results of our study led the Athletic Department to mandate the ECG as part of the PPE in 2010. In 2010 we used a lapto analog to digital ECG system and our own software to perform the screening on Stanford collegiate athletes and the San Francisco 49ers. Our software is designed for screening athletes and the output states wheither an athlete needs further evaluation prior to participation or not. This differs from the available commercial interpretive programs which often give confusing statement when testing athletes. Our recommendation statement with a concensus of an international group of experts providing specific criteria for ECG diagnoses that require further evaluation prior to participation has been published.  We are trying to address the confusion between classic "early repolarization" based on ST elevation and the new channelopathies classified as "early repolarization" based on R wave downslope phenomena (aka J wave syndromes). 

Selected Papers


From the Seattle Symposium 2012, Drezner et al.