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2015 ; 30
(5
): 440-6
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gab.com Text
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English Wikipedia
The Prevalence of Clinical and Electrocardiographic Risk Factors of
Cardiovascular Death Among On-duty Professional Firefighters
#MMPMID24874885
Al-Zaiti SS
; Carey MG
J Cardiovasc Nurs
2015[Sep]; 30
(5
): 440-6
PMID24874885
show ga
BACKGROUND: Firefighters have twice as many cardiovascular deaths as police
officers and 4 times as many as emergency medical responders. The etiology for
this high rate of mortality remains unknown. The electrocardiogram (ECG) is a
widely used tool to screen populations at risk, yet there are no available
on-duty, high-resolution ECG recordings from firefighters. OBJECTIVE: We sought
to evaluate the prevalence of clinical and ECG risk factors among on-duty
professional firefighters during 12-lead ECG holter monitoring and exercise
stress testing. METHODS: Firefighters were recruited from Surveying & Assessing
Firefighters Fitness & Electrocardiogram (SAFFE) study. This descriptive study
recruited firefighters from 7 firehouses across Upstate New York who completed
on-duty 24-hour Holter ECG monitoring and a standard exercise stress test. All
analyses were completed by a reviewer blinded to all clinical data. RESULTS: A
total of 112 firefighters (mean [SD] age, 44 [8] years; mostly white men)
completed the study. Although all firefighters were in normal sinus rhythm, more
than half of them had at least 1 high-risk ECG risk factor present, including
abnormal sympathetic tone (elevated heart rate, 54%), abnormal repolarization
(wide QRS-T angle, 25%), myocardial scarring (fragmented QRS, 24%), and
myocardial ischemia (ST depression, 24%). Most firefighters tolerated the
treadmill exercise stress test well (metabolic equivalent tasks, 11.8 + 2.5]);
however, almost one-third had abnormal results of stress tests that required
further evaluation to rule out subclinical coronary artery disease. CONCLUSIONS:
Among on-duty professional firefighters, high-risk ECG markers of fatal cardiac
events and abnormal stress test results that warrant further evaluation are
prevalent. Annual physical checkups with routine 12-lead ECG can identify those
who might benefit from preventive cardiovascular services.