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Med J Armed Forces India. 2015 Oct;71(4):324-9. doi: 10.1016/j.mjafi.2015.06.010. Epub 2015 Aug 31.

The prevalence of abnormal ECG in trained sportsmen.

Author information

1
Sports Physiologist, Army Sports Institute, Pune 411036, India.
2
Classified Specialist (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi, 110011, India.
3
Commanding Officer, Army Sports Institute, Pune 411036, India.
4
Senior Adviser (Medicine) and Cardiology, Military Hospital (Cardiothoracic Center), Pune 411040, India.
5
Consultant (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India.
6
Senior Adviser (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India.
7
Consultant (Medicine) and Cardiologist, & Commandant, Armed Forces Clinic, Dalhousie Road, New Delhi 110001, India.
8
Senior Adviser (Medicine) and Cardiology, Command Hospital (Southern Command), Pune 411040, India.
9
Classified Specialist (Medicine) and Cardiologist, Military Hospital Jalandhar, Punjab, India.
10
Nursing Assistant (Cardiology), Command Hospital (Southern Command), Pune 411040, India.

Abstract

BACKGROUND:

Competitive sports training causes structural and conductive system changes manifesting by various electrocardiographic alterations. We undertook this study to assess the prevalence of abnormal ECG in trained Indian athletes and correlate it with the nature of sports training, that is endurance or strength training.

METHODS:

We evaluated a standard resting, lying 12 lead Electrocardiogram (ECG) in 66 actively training Indian athletes. Standard diagnostic criteria were used to define various morphological ECG abnormalities.

RESULTS:

33/66 (50%) of the athletes were undertaking endurance training while the other 33 (50%) were involved in a strength-training regimen. Overall 54/66 (81%) sportsmen had significant ECG changes. 68% of these changes were considered as normal training related features, while the remaining 32% were considered abnormal. There were seven common training related ECG changes-Sinus Bradycardia (21%), Sinus Arrhythmia (16%), 1st degree Atrioventricular Heart Block (6%), Type 1 2nd-degree Atrioventicular Heart Block (3%), Incomplete Right bundle branch block (RBBB) (24%), Early Repolarization (42%), Left Ventricular Hypertrophy (LVH) (14%); while three abnormal ECG changes--T-wave inversion (13%), RBBB(4%), Right ventricular hypertrophy (RVH) with strain (29%) were noted. Early repolarization (commonest change), sinus bradycardia, and incomplete RBBB were the commoner features noticed, with a significantly higher presence in the endurance trained athletes.

CONCLUSION:

A high proportion of athletes undergoing competitive level sports training are likely to have abnormal ECG recordings. Majority of these are benign, and related to the physiological adaptation to the extreme levels of exertion. These changes are commoner during endurance training (running) than strength training (weightlifting).

KEYWORDS:

Competitive sports training; Electrocardiography; Endurance training; Sports cardiology; Strength training

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