Q&A with Dr Jessica Orchard
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Q&A with Dr Jessica Orchard

Cardiac screening of athletes: disparities and differences in electrocardiogram (ECG) interpretation criteria in under-represented populations

Dr Jessica Orchard is a Heart Foundation Postdoctoral Fellow at The University of Sydney. She is also an Adjunct Senior Lecturer at the Centenary Institute and University of Sydney.

Dr Jessica Orchard’s PhD was awarded in November 2020. She also has a Master of Public Health, and Bachelor of Economics / Bachelor of Laws from the University of Sydney. Dr Orchard became a Fellow of the European Society of Cardiology in 2019. Her research aims to improve the quality of cardiac screening programs to prevent sudden cardiac death and catastrophic disability from stroke. Sudden cardiac death refers to a sudden death that is caused by a heart condition.

Dr Orchard presented work on an atrial fibrillation screening program (atrial fibrillation is a type of rhythm problem where the heart beats irregularly and often fast) at the Cardiac Society of Australia and New Zealand (CSANZ) conference in 2020. She won the CSANZ Prevention Prize for her presentation entitled: Atrial Fibrillation Screen, Management and Guideline Recommended Therapy (AF SMART II) in the rural primary care setting: cost-effective eHealth tools to support all stages of screening.  

What are you currently researching?

My project aims to improve the accuracy of cardiac screening programs to prevent sudden cardiac death in young athletes. I will specifically focus on populations that are under-represented in current guidelines, including female and Australian Indigenous athletes. I will collect new data from athletes of various ethnicities and female athletes across multiple sports to identify any differences in electrocardiogram (ECG) features.  An ECG is a test which involves attaching dots and leads to your skin to measure the heart’s electrical activity.

In addition, we know that screening and traditional monitors (such as Holter monitors) cannot capture all arrhythmias (faults in the heart’s electrical system, which affects the heart’s pumping rhythm). I will trial new smartphone ECGs (iECGs) to see if they can effectively capture arrhythmias occurring during high-intensity exercise which can be difficult to detect.  Accurate diagnosis is important to identify people at  high risk of sudden cardiac death while exercising.  

What difference will your research make to people’s cardiovascular health in Australia?

My research program aims to improve the quality and accuracy of athlete cardiac screening for under-represented populations (such as Australian Indigenous and female athletes). Our data will contribute to an improved understanding of the ECG features of these groups, which may lead to changes in guidelines and clinical practice. In addition, we will be the first to investigate innovative smartphone ECG technology use in elite sport to diagnose and monitor exercise-induced arrhythmias. This highly portable and affordable technology may be able to capture arrhythmias previously missed by traditional monitors.

The ultimate aim is to improve the quality of screening programs to reduce sudden cardiac death in athletes, independent of ethnicity or sex, thereby improving cardiovascular care and preventing premature cardiovascular deaths.

What motivated you to do your research?

Screening programs must be based on the best available evidence. Delivering a best practice program is central to maximising the benefits and minimising possible harms of screening, such as the risk of false positives (where a person’s screening test is positive but they do not actually have the condition) which may result in additional tests and anxiety.

My research aims to improve the quality of cardiac screening programs to prevent sudden cardiac death and catastrophic disability from stroke. These projects have used novel eHealth tools and have made best practice recommendations. They have considered legal and ethical responsibilities associated with cardiac screening among athletes such as whether screening is mandatory, consent issues, follow-up testing for abnormal screening results, and impacts on health insurance.

Do you have a message for Heart Foundation supporters?

Thank you for your generous support of the Heart Foundation. Your support allows me to continue my research into cardiac screening programs in athletes and the use of new technology to detect arrhythmias. The ultimate aim of my research is to improve the quality of screening programs to save lives by identifying athletes at high risk of sudden cardiac death.

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