Developing Canada's First Centre of Excellence for the Cardiovascular Screening and Care of the Athlete Program
Quality Improvement & Outcomes
Sudden cardiac death in active individuals is a tragic public health concern. To prevent these unexpected events and improve the cardiovascular care of athletes, our institution implemented Canada’s first Centre of Excellence for the Cardiovascular Screening and Care of the Athlete Program. We piloted a cardiovascular athletic screening program for young athletes, demonstrating program feasibility and efficiency. Through this program, we validated a novel community-conducted electrocardiogram workflow approach, thus reducing institutional screening costs and resource requirements. We also developed a novel online screening platform (CATCHNet Screening Portal), which allows health care providers to organize athletic screening requests and review clinical data, all while contributing to a research registry. This platform will revolutionize athletic health care delivery, standardize screening procedures, and facilitate national research initiatives through harmonized data collection.
Sudden cardiac death (SCD) in active individuals is a tragic public health concern. To identify athletes at risk of SCD, pre-participation screening (PPS) is recommended by numerous international medical societies. However, there is substantial variability in PPS across Canada and no centralized system to conduct screening. Following recent Canadian recommendations, Queen’s University piloted a multidisciplinary PPS program. Program feasibility was demonstrated on a cohort of 517 athletes who participated in routine screening from 2017-2018. This program will serve as a blueprint for other Canadian institutions intending to implement a formal PPS model. To reduce the institutional cost and resource burden of electrocardiogram (ECG) screening, we validated a novel workflow approach, which outsourced ECG requisitions to each athlete’s primary care network. Among 740 athletes who underwent PPS from 2017-2021, community-conducted athletic ECGs were shown to be interpreted with high agreement (95.1%) to international ECG standards, with no false-negative interpretations. Recognizing the need for an efficient and standardized approach to PPS, we developed a novel online screening platform, which allows health care providers to organize athletic screening requests and review patient information, all while contributing to a research registry. This platform will revolutionize athletic health care delivery, standardize screening procedures, and facilitate national research initiatives through harmonized data collection (www.catchnet.ca). The CATCHNet Screening Portal is available for implementation within institutions and organizations across Canada. Leveraging this tool, we have received funding from AMS Healthcare to conduct a mixed-methods study investigating the psychological implications of cardiovascular PPS on athletes.
- Williamson M, Grubic N, Moulson N, Johri AM. Evaluation of a community-conducted electrocardiogram model for athletic cardiovascular screening: primary care network versus sports cardiology interpretation J Electrocardiol. https://doi.org/10.1016/j.jelectrocard.2023.07.007.
- Grubic N, Johri AM, on behalf of the CATCH Network. Development of an Online Cardiovascular Pre-participation Screening Tool: The Community & Athletic Cardiovascular Health Network Screening Portal. Can J Cardiol. 2023;39(7):883-885. https://doi.org/10.1016/j.cjca.2023.03.008.
- Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: A systematic review. Br J Sports Med. 2022;56;410-416. https://doi.org/10.1136/bjsports-2021-104623.
- Grubic N, Baranchuk M, Johri AM. An Athlete’s Journey Through Cardiovascular Screening: Applying a Non-Binary Approach to Sports Participation/Restriction Using Shared-Decision Making. Can J Cardiol. 2019;35(7):941.e3-941.e4. https://doi.org/10.1016/j.cjca.2019.04.013.
- Johri AM, Grubic N, Kuljic N, O’Connor M, Graham K, Bennett R, et al. Translation of the Canadian Cardiovascular Society/Canadian Heart Rhythm Society Cardiovascular Screening and Care of Athletes Program into Practice. Can J Cardiol. 2019;35(7):935-939. https://doi.org/10.1016/j.cjca2019.03.026.