ECG-Screening for young elite athletes Abstract Background Sudden cardiac death (SCD) during physical activity is a frightening and emotional tragedy that draws huge media attentions when it occurs. Fortunately it is a relatively uncommon occurrence but happens nonetheless to young athletes who often seems to be in perfect health. SCD is used as a term for sudden unexpected complications on the cardiovascular system that leads to a deadly outcome normally within the first hour of onset of symptoms and the cause is some sort of underlying cardiovascular disease that gets triggered by physical activity.Normally athletes gets divided into two groups dependent on age, over and under 35 years, and this studies focus is on the younger group since it is often during this period athletes are at the elite level. It is also in this category the most unexpected sudden deaths occur that is not due to coronary atherosclerosis, which is the dominant cause of death, and drastically increases, for people over 35 years old. Aim The aim of this study was to scientific and unbiased analyze peer-reviewed clinical articles todescribe the pros, cons and cost to implement an ECG-screening as a standard before physicalactivities for specifically defined elite athletes. Method A systematic review was performed and after all data collection 21 articles was chosen to beused as a base for both background and analyze. At the end 10 articles was fulfilling the criteria to be used at the analyze and later the results. Results The implementation of ECG-screening has reduced SCD in Italy by 89 % between the years 1979-2004. There is a higher risk of SCD for active elite athletes. ECG-screening could be aneffective way to detect hypertrophic cardiomyopathy but a similar study showed oppositeresult. The positive negative results from ECG are relatively low. Hypertrophiccardiomyopathy is a rare disease among elite athletes. A standardized help tool for ECG can help all sorts of physicians in judging the results from ECG. The cost for implementation ofECG-screening for all young athletes is high and will probably not be implemented in countries like USA for a foreseable future. Discussion There is a lot of studies done on the matter but only a couple has shown any positive numbers that gives the implementation of en ECG-screening actually reduce the mortality to SCD. More studies are published every year and the debate will probably go on for a long time, especially concerning money and resources but also about its effectiveness. Better technology in the future will probably make it a more affordable project, especially if it develops to be amore efficient tool.