The setting up of a national cardiac screening programme for all young people in the State in the hope of detecting those at risk of sudden cardiac death has been ruled out by an expert group.
The national taskforce on sudden cardiac death, whose recommendations are due to be sent to Minister for Health Mary Harney shortly, is expected to recommend screening for all young people involved in competitive sports and for the families of victims of sudden cardiac death.
Taskforce chairman Dr Brian Maurer said his group had looked at all the options.
He told The Irish Times: "I think it's fair to say that we will not be recommending mass population screening and the simple reason for that is that the tools that we have for screening populations don't fit the criteria for cost effectiveness."
He said that if such screening were done it would be found that about one in five children had some kind of abnormality and the result would be to discourage 25,000 children a year from playing sport "in order to possibly save five lives or less in any one year".
Asked if it would be a good idea then to screen people involved in sport, Dr Maurer, said: "Yes, I think there is a difference between people who are going into high performance sports or professional sports and between kids who want to play on the school playground."
He said the group would be making recommendations about steps that should be taken by major sporting organisations.
The Irish Rugby Football Union already had a screening programme. "That looks to me like a good model."
Dr Maurer, a consultant cardiologist at Dublin's St Vincent's hospital and medical director of the Irish Heart Foundation, was speaking after addressing the second national conference on the prevention of sudden cardiac death at UCD on Saturday.
The taskforce was set up last year in the wake of public concern about what appeared to be an increased incidence of sudden cardiac death among young sportsmen like the late Tyrone footballer Cormac McAnallen.
Dr Maurer said the taskforce had looked at the overall incidence of sudden cardiac death in the Republic and believed there were between 5,000 and 6,000 such deaths a year. The vast majority of them were in middle aged and older people as a result of coronary artery disease brought on by lifestyle factors such as diet and smoking. And about 50 to 70 of the deaths were in young people.
He said that in young people the problems were more specific, and deaths were often caused by conditions such as cardiomyopathies and channelopothies.
He said it had become apparent that "if you look at the families of young people who have been the victims of sudden death you can identify others who are potentially at risk and you can take steps to reduce the risk of sudden death. You can't abolish the risk but you can reduce it".
The taskforce would recommend screening for all families in such cases.
The taskforce also wants counselling provided for these families, a register kept of all such deaths and specialist pathologists with an interest in heart disease appointed who would recognise rare heart conditions when they did postmortems on young people who had died suddenly. It also wants such deaths recorded on death certificates.
In addition, the taskforce will recommend that all health service personnel be trained in basic life support - not all ambulance drivers have such training at present.
It will also call for changes in the way emergency services are organised and for more defibrillators to be provided in rural communities to help ensure that people in isolated areas have the same chance of survival as those in cities.
If all these elements were in place 40 to 50 per cent of people could be saved. If nothing is done, as is often the case at present, only 1 per cent of people survive.