Background Firefighters have twice as many cardiovascular deaths as police officers and four times NNC 55-0396 as many as emergency medical responders. were recruited from Surveying and Assessing Firefighters Fitness and ECG (SAFFE) study. This descriptive study recruited firefighters from 7 firehouses NNC 55-0396 across Western New York area who all completed on-duty 24 Holter ECG monitoring and a standard exercise stress test. All analyses were completed by a reviewer blinded to all clinical data. Results 112 firefighters (age 44±8 years mostly white males) completed the study. Even though all firefighters were in normal sinus rhythm over half of them had at least one high risk ECG risk factor present including abnormal sympathetic tone (elevated heart rate 54 abnormal repolarization (wide QRS-T angle 25 myocardial scaring (fragmented QRS 24 and myocardial ischemia (ST Rabbit Polyclonal to OR4A15. depression 24 In addition most firefighters tolerated the treadmill exercise stress test well (metabolic equivalent tasks 11.8+2.5) however almost one third had abnormal stress tests that require further evaluation to rule out subclinical coronary artery disease. Conclusion 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. Keywords: Electrocardiogram Firefighters Risk Stratification INTRODUCTION In 2005 the National Fire Protection NNC 55-0396 NNC 55-0396 Association reported that 44% of on-duty firefighter fatalities were due to sudden cardiac death.1 Two years later Kales and colleagues2 confirmed that 45% of on-duty firefighter deaths were cardiac related so that many are actually dying of cardiac disease rather than of fire-related injuries. On-duty firefighters have twice as many cardiovascular deaths as police officers and four times as many as emergency medical responders.2 The exact etiology why this unique population has relatively higher risk for cardiovascular events is unknown. We previously reported on the prevalence of metabolic syndrome coronary artery disease sleep deprivation binge drinking behaviors and overall poor mental well-being among professional firefighters 3 all of which are known to increase the risk for cardiovascular events. To date despite the high cardiac risk for firefighters and its NNC 55-0396 societal importance there are no available high resolution field recordings of the electrocardiogram (ECG) during firefighting activities. Consequently the aim of this study was to evaluate the prevalence of clinical and ECG risk factors among on-duty professional firefighters. METHODS Subjects for this study were recruited from Surveying & Assessing Firefighters Fitness & Electrocardiogram (SAFFE) study between 2008 and 2010. SAFFE Study was a cross-sectional descriptive study that recruited professional firefighters from Western New York (WNY) area. Out of 13 accessible firehouses in WNY area the research team travelled across seven of these firehouses and professional firefighters were approached while on-duty to participate in the study. Research equipment and supplies were moved from one firehouse to the other to allow all eligible firefighters equal chances for voluntary participation. Since professional firefighters have a physician clearance to be on-duty no exclusion criteria were applied. NNC 55-0396 Firefighters in WNY area undergo a one-time physical assessment prior to becoming firefighters and then get enrolled in an optional occupational health monitoring program in a county hospital. Firefighters who consented to participate anonymously completed paper-and-pencil surveys and then in a private bunk room research personnel obtained anthropometric measures (i.e. height weight abdominal circumference and abdominal height) and vital signs (i.e. baseline blood pressure and heart rate). Two blood pressure readings were taken 5-minute apart after resting in chair for 5-minutes. Each firefighter then completed a symptom-limited standard Bruce exercise treadmill test (ETT) followed by ambulatory 12-lead ECG holter recording for 24 hours. The ECG monitoring was done.