Corrado and colleagues reply to Van Brabandt and colleagues

We read with interest Van Brabandt and colleagues’ review questioning the utility of pre-participation screening in preventing sudden cardiac death (SCD) in sports activity.1 The paper is not a balanced “pro and cons” analysis; rather, it seems to be a direct attack on the Italian screening programme and on the researchers who provided scientific evidence that cardiovascular evaluation of athletes is a lifesaving strategy based on more than 30 years’ experience in the Veneto region, northeast Italy.2 3 4 5 6 The paper was signed by laypersons with no experience in the field of sports cardiology, who provided a personal viewpoint and omitted the “real world” opinion of thousands of international physicians daily involved in athlete evaluation who favoured the need for pre-participation screening.7 The authors started by mistakenly reporting that Italy’s screening of competitive athletes has been mandatory since 1979. Instead, screening has been in place by law in Italy since 1982,8 which would be the correct starting point for evaluating its impact on mortality. This initial inaccuracy jeopardises the entire analysis. The inaccuracy is confirmed by the authors’ statement that the usefulness of ECG screening is confined to detecting athletes with Wolff-Parkinson-White syndrome, when in fact the main strength is …