JOINT BASE SAN ANTONIO-LACKLAND, Texas –
Sudden cardiac arrest (SCA) remains a persistent threat to military readiness, with more than 200 cardiac arrests among active duty service members each year. In response, a groundbreaking pilot program is working to change that. Capt. (Ret.) M. Alaric Franzos, an Associate Professor at the Uniformed Services University and a staff cardiologist at Walter Reed National Military Medical Center, is leading the charge through ERASE: the Electrocardiogram (ECG) Risk Assessment to reduce Sudden cardiac Events.
ERASE: Reviving a Lifesaving Screen for Military Recruits
Originally discontinued in 2002 due to high false positive rates, routine ECG screening is now making a return—backed by modern medical advancements and Congressional support. The ERASE initiative evaluates the feasibility, scalability, and sustainability of resuming ECG screenings across the Department of Defense.
“Every year, over 200 active duty personnel suffer sudden cardiac arrest,” Franzos said. “It devastates families, units, and missions. We now have the tools to screen more accurately and save lives.”
ERASE was first launched at the U.S. Naval Academy following three unexpected SCAs among Midshipmen. The success of that program prompted Congress to mandate expansion to all Service Academies and a basic training site—Joint Base San Antonio-Lackland.
A Streamlined Process with Potential Life-Saving Impact
The ERASE process begins with a standardized questionnaire covering personal and family history, followed by blood pressure readings and a resting ECG. If any abnormal readings appear, the trainee undergoes a clinical evaluation which may lead to a follow-up echocardiogram to assess the heart’s structure and function.
“Most trainees return to duty immediately,” Franzos explained. “Disqualification is rare—only four out of every 10,000—but we’ve identified life-threatening conditions in asymptomatic individuals who had no idea they were at risk.”
In some cases, early detection has led to advanced interventions like implantable defibrillators, which would not have occurred without the ERASE screening.
From Pilot to Potential Policy
The pilot program at the Air Force’s Basic Military Training began with testing 200 trainees per week, validating a new information technology system for uploading ECGs and echocardiograms into MHS GENESIS, the military’s electronic health record. After proving successful, the program scaled up to screen 500 trainees daily and is on track to cover entire BMT classes of nearly 900.
While still in the feasibility stage, the implications are far-reaching.
“ERASE could significantly reduce sudden cardiac arrests within the active duty force,” Franzos said. “We’re particularly focused on those deploying to austere environments where medical resources are limited. Early detection enhances both health and operational confidence.”
Looking Forward: Data-Driven Decisions for Military Medicine
Beyond its immediate screening benefits, ERASE is gathering essential data to inform future policy decisions on whether and where best to implement cardiac screening—at basic training locations or initial medical accession sites like Military Entrance Processing Stations.
“ERASE is more than a screening program,” Franzos said. “It’s a data-driven approach to possibly saving lives, improving readiness, and modernizing how we care for the heart of the force.”
As military medicine evolves, programs like ERASE—anchored in research and driven by operational necessity—are leading the way toward a healthier, more resilient future for America’s warfighters.