Supporting a Research on Cardiopathy among Youth and Children

Project location: ITALY, Rome
Project start date: June 2010 - Project end date: September 2011
Project number: 2010-22

The aim of this project, co-funded by the Nando Peretti Foundation, is to identify, by recording a surface ECG, potential candidates to Sudden Death in the High School population.
Sudden cardiac death is natural death from cardiac causes, heralded by abrupt loss of consciousness within one hour of the onset of acute symptoms. Other forms of sudden death may be noncardiac in origin. Examples of this include respiratory arrest (such as due to airway obstruction, which may be seen in cases of choking or asphyxiation), toxicity or poisoning, anaphylaxis, or trauma.
Every year in Italy approximately 5000 young persons die suddenly.
The majority of these deaths are due to congenital electrical diseases of the hearth (so called "Arrhythmogenic cardiomyopathies").
The most important of them are the long QT syndrome, the short QT syndrome, the Brugada syndrome, the Arrhythmogenic Right Ventricular Dysplasia.

In nearly all these pathologies a simple surface ECG could identify the patients affected by one of them and allow the physician to apply all the diagnostic and therapeutical processes to avoid Sudden Death.
The age of the addressed student population will be between 14 and 18 years.
A team of nurses and doctors working in the Cardiovascular Department of the S. Filippo Neri Hospital in Rome, will examine 10.000 students (approximately 40 persons per day for 300 working days) with the following flowchart:

recording a surface 12 leads ECG looking for any type of abnormalities.

1. measuring blood pressure
2. measuring body weight
3. measuring the student's height
4. distributing to the students a very simple questionnaire to investigate their type of life and cardiovascular risk factors (smoke, no physical activity, obesity, alcohol assumption etc).
All the ECG clinical data, and questionnaires will be examined by the physicians involved in the project.
In the case of ECG abnormalities the student will be invited to perform further investigations.
The parents will obviously be involved for all the students younger than 18.
The ICAD project will end with the evaluation of the data and their publication.

The ICAD study is more a feasibility study than a large population study.
To hypothesize the results in terms of numbers is not easy, as we do not have preexisting data on the prevalence of Arrhythmogenic cardiac diseases in the young population. Should it appear easy, cost-beneficial and well acceptable, it could be expanded on a national base and then certainly contribute significantly to save lives.
Furthermore there will be a large amount of data on cardiovascular risk factors, at present not available which, if reduced, could decrease significantly the incidence of myocardial ischemia, infarction, and cerebral ictus in the next twenty years of life of our students. Finally, the impact of this new methodology of education and scientific investigation on a difficult population as the youth, could be tested.

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