Are the QRS duration and ST depression cut-points from the Seattle criteria too conservative?

Journal of Electrocardiology
Tim DunnVictor Froelicher

Abstract

Screening athletes with ECGs is aimed at identifying "at-risk" individuals who may have a cardiac condition predisposing them to sudden cardiac death. The Seattle criteria highlight QRS duration greater than 140 ms and ST segment depression in two or more leads greater than 50 μV as two abnormal ECG patterns associated with sudden cardiac death. High school, college, and professional athletes underwent 12 lead ECGs as part of routine pre-participation physicals. Prevalence of prolonged QRS duration was measured using cut-points of 120, 125, 130, and 140 ms. ST segment depression was measured in all leads except leads III, aVR, and V1 with cut-points of 25 μV and 50 μV. Between June 2010 and November 2013, 1595 participants including 297 (167 male, mean age 16.2) high school athletes, 1016 (541 male, mean age 18.8) college athletes, and 282 (mean age 26.6) male professional athletes underwent screening with an ECG. Only 3 athletes (0.2%) had a QRS duration greater than 125 ms. ST segment depression in two or more leads greater than 50 μV was uncommon (0.8%), while the prevalence of ST segment depression in two or more leads increased to 4.5% with a cut-point of 25 μV. Changing the QRS duration cut-point to 125 ms would increase ...Continue Reading

References

Jul 11, 2006·The American Journal of Medicine·Aseem D DesaiVictor F Froelicher
Jul 31, 2007·The American Journal of Cardiology·Sergio BongioanniMaria Rosa Conte
Jan 24, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Majid HaghjooMohammad Ali Sadr-Ameli
Jan 11, 2013·British Journal of Sports Medicine·Jonathan A DreznerMathew G Wilson

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Citations

Oct 4, 2016·Cardiology Clinics·Tee Joo Yeo, Sanjay Sharma
Mar 5, 2017·British Journal of Sports Medicine·Jonathan A DreznerDomenico Corrado
Mar 23, 2017·European Heart Journal·Sanjay SharmaDomenico Corrado

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