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Br J Sports Med. 2017 May;51(9):704-731. doi: 10.1136/bjsports-2016-097331. Epub 2017 Mar 3.

International criteria for electrocardiographic interpretation in athletes: Consensus statement.

Author information

1
Department of Family Medicine, University of Washington, Seattle, Washington, USA.
2
Cardiology Clinical Academic Group, St. George's, University of London, London, UK.
3
Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, US.
4
Department of Sports Medicine, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
5
Division of Cardiology, University of Washington, Seattle, Washington, USA.
6
Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
7
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
8
Department of Paediatric, Mayo Clinic, Rochester, Minnesota, USA.
9
Department of Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
10
Department of Molecular Pharmacology, Mayo Clinic, Rochester, Minnesota, USA.
11
Department of Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.
12
Department of Neuroscience, Sahlgrenska University Hospital/Ostra Sahlgrenska Academy, Goteborg, Sweden.
13
Department of Physiology, Sahlgrenska University Hospital/Ostra Sahlgrenska Academy, Goteborg, Sweden.
14
Department of Pediatrics, University of Washington, Seattle, Washington, US.
15
Department of Family Medicine, University of South Carolina, Greenville, USA.
16
Division of Cardiology, University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA.
17
Center of Cardiovascular Care in Athletics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
18
Department of Medicine, Stanford University, Stanford, California, USA.
19
Hasselt University, Hasselt, Belgium.
20
Georgia Southern University, Statesboro, Georgia, USA.
21
Division of Paediatric Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.
22
Division of Cardiothoracic Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.
23
Advocate Heart Institute, Chicago, Illinois, USA.
24
Division of Pediatric, Baylor College of Medicine, Houston, Texas, USA.
25
Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA.
26
University Institute of Sports Medicine, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
27
Center for Inherited Cardiovascular Disease, Stanford University, Stanford, California, USA.
28
Department of Pediatrics, Cleveland Clinic, Cleveland, Ohio, USA.
29
Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
30
University Heart Center, Zurich, Switzerland.
31
Heart Centre of Philadelphia, Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
32
Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
33
The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
34
Institute of Sports Medicine and Science, Rome, Italy.
35
Department of Cardiac Science, University of Padua Medical School, Padua, Italy.
36
Department of Thoracic Sciences, University of Padua Medical School, Padua, Italy.
37
Department of Vascular Sciences, University of Padua Medical School, Padua, Italy.

Abstract

Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly, advanced by a growing body of scientific data and investigations that both examine proposed criteria sets and establish new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington (USA), to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

KEYWORDS:

Athlete; Cardiovascular; Sudden cardiac arrest; Sudden cardiac death

PMID:
28258178
DOI:
10.1136/bjsports-2016-097331
[Indexed for MEDLINE]

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