Preventing sudden cardiac death in the young: Is electrocardiogram screening the most effective means?

The sudden and unexpected death of a young person is an infrequent event, although it has become an important public health issue. Factors contributing to the increasing profile are the long-standing debates over pre-participation screening for young athletes, the apparent success of this screening in some jurisdictions, as well as concerns about the possible risk of stimulant medication for attention-deficit hyperactivity disorder. In fact, this latter consideration resulted in a recent document (1) from the American Heart Association that devoted a large portion to discussion of the issues related to the usefulness of electrocardiogram (ECG) screening.