People at low risk for heart trouble may not need routine ECGs

In the journals

Published: December, 2017

A study published in the September 2017 issue of JAMA Internal Medicine found that doctors may prescribe an electrocardiogram (ECG) as part of an annual health examination even for people at low risk for heart disease. The study looked at about 3.6 million people with no history of heart problems, like heart attack, high blood pressure, or diabetes, who had at least one routine exam over a five-year period. Of these people, 21.5% had an ECG within 30 days after their exam.

The researchers found that those who got the ECG were five times more likely to get further cardiology testing that not only increased out-of-pocket costs, but also raised their risks of radiation exposure and complications from additional procedures. The addition of an ECG did not appear to offer additional benefits, as the rates of death, heart-related hospitalizations, and bypass surgery were equally low in both the ECG and non-ECG groups at the one-year follow-up.

The use of ECGs may reflect the doctor's preference. More than 8,000 primary care physicians were cited in the study, and some were almost 90 times more likely to order an ECG than others. The researchers noted that their study does not prove ECGs are always unnecessary; doctors may find something of concern during an exam that would require further insight from an ECG. But for most low-risk people, they appear to offer no clear benefit with many potential downfalls.

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