Department of Cardiology, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK.
Cardiology Clinical Academic Group, Molecular and Clinical Sciences Research Institute, St. George's, University of London University of London, UK.
Europace. 2021 Aug 6;23(8):1295-1301. doi: 10.1093/europace/euab021.
There is limited information on the role of screening with electrocardiography (ECG) for identifying cardiovascular diseases associated with sudden cardiac death (SCD) in a non-select group of adolescents and young adults in the general population.
Between 2012 and 2014, 26 900 young individuals (aged 14-35 years) were prospectively evaluated with a health questionnaire and ECG. Individuals with abnormal results underwent secondary investigations, the costs of which were being based on the UK National Health Service tariffs. Six hundred and seventy-five (2.5%) individuals required further investigation for an abnormal health questionnaire, 2175 (8.1%) for an abnormal ECG, and 114 (0.5%) for both. Diseases associated with young SCD were identified in 88 (0.3%) individuals of which 15 (17%) were detected with the health questionnaire, 72 (81%) with ECG and 2 (2%) with both. Forty-nine (56%) of these individuals received medical intervention beyond lifestyle modification advice in the follow-up period of 24 months. The overall cost of the evaluation process was €97 per person screened, €17 834 per cardiovascular disease detected, and €29 588 per cardiovascular disease associated with SCD detected. Inclusion of ECG was associated with a 36% cost reduction per diagnosis of diseases associated with SCD compared with the health questionnaire alone.
The inclusion of an ECG to a health questionnaire is associated with a five-fold increase in the ability to detect disease associated with SCD in young individuals and is more cost effective for detecting serious disease compared with screening with a health questionnaire alone.
在一般人群中的非选择性青少年和年轻成年人中，使用心电图（ECG）进行筛查以识别与心源性猝死（SCD）相关的心血管疾病的作用的相关信息有限。
在 2012 年至 2014 年期间，对 26900 名年龄在 14-35 岁的年轻人进行了健康问卷和心电图检查。对结果异常的个体进行了二级检查，其费用基于英国国家医疗服务体系的收费标准。有 675 名（2.5%）个体的健康问卷结果异常需要进一步调查，2175 名（8.1%）的心电图结果异常，114 名（0.5%）两项结果均异常。在 88 名（0.3%）与年轻 SCD 相关的疾病个体中发现了与年轻 SCD 相关的疾病，其中 15 名（17%）通过健康问卷发现，72 名（81%）通过心电图发现，2 名（2%）通过两项检查发现。在 24 个月的随访期间，这些个体中有 49 名（56%）接受了生活方式改变建议以外的医疗干预。评估过程的总成本为每人 97 欧元，每发现一种心血管疾病为 17834 欧元，每发现一种与 SCD 相关的心血管疾病为 29588 欧元。与仅使用健康问卷相比，将心电图纳入健康问卷可使 SCD 相关疾病的诊断成本降低 36%。
与仅使用健康问卷相比，将心电图纳入健康问卷可使年轻人中与 SCD 相关的疾病的检出率提高五倍，并且在检测严重疾病方面比仅使用健康问卷筛查更具成本效益。
