BEAT-IT: A de-novo cardiac screening program in Maltese Adolescents.

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.