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Rev Esp Cardiol (Engl Ed). 2017 Nov;70(11):983-990. doi: 10.1016/j.rec.2017.08.015. Epub 2017 Sep 18.

Comments on the New International Criteria for Electrocardiographic Interpretation in Athletes.

[Article in English, Spanish]

Author information

Servicio de Rehabilitación, Fisioterapia y Medicina del Deporte, Unidad de Cardiología del Deporte, Hospital Universitario Quirónsalud, Pozuelo de Alarcón, Madrid, Spain. Electronic address:
Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Servicio de Cardiología Deportiva, Hospital IMED Levante, Elche, Alicante, Spain.
Instituto Cardiovascular, Hospital Clínic, Barcelona, Spain.
Unidad de Rehabilitación Cardiaca y Valoración Funcional, Hospital Universitario de Basurto, Unidad de Rehabilitación Cardiaca del IMQ, Bilbao, Vizcaya, Spain.
Department of Sports Medicine, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.


Sudden cardiac death is the most common medical cause of death during the practice of sports. Several structural and electrical cardiac conditions are associated with sudden cardiac death in athletes, most of them showing abnormal findings on resting electrocardiogram (ECG). However, because of the similarity between some ECG findings associated with physiological adaptations to exercise training and those of certain cardiac conditions, ECG interpretation in athletes is often challenging. Other factors related to ECG findings are race, age, sex, sports discipline, training intensity, and athletic background. Specific training and experience in ECG interpretation in athletes are therefore necessary. Since 2005, when the first recommendations of the European Society of Cardiology were published, growing scientific evidence has increased the specificity of ECG standards, thus lowering the false-positive rate while maintaining sensitivity. New international consensus guidelines have recently been published on ECG interpretation in athletes, which are the result of consensus among a group of experts in cardiology and sports medicine who gathered for the first time in February 2015 in Seattle, in the United States. The document is an important milestone because, in addition to updating the standards for ECG interpretation, it includes recommendations on appropriate assessment of athletes with abnormal ECG findings. The present article reports and discusses the most novel and relevant aspects of the new standards. Nevertheless, a complete reading of the original consensus document is highly recommended.


Athlete; Deportista; Electrocardiogram; Electrocardiograma; Reconocimiento médico; Screening

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