Electrocardiograms in athletes: interpretation and diagnostic accuracy

Medicine and Science in Sports and Exercise
Christine E Lawless, Thomas M Best

Abstract

Electrocardiography (ECG) has been proposed as a method to enhance the ability of the preparticipation examination (PPE) to detect underlying cardiac conditions that can lead to sudden cardiac death (SCD) in young athletes. We conducted a Medline review of the published medical literature, using the key terms of cardiovascular screening of athletes, ECG in athletes, SCD in athletes, and ECG in specific cardiac disease states: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy, myocarditis, long QT syndrome, Brugada syndrome, coronary artery anomalies, myocardial bridging, aortic stenosis, mitral valve prolapse, and Marfan syndrome. ECG seems to increase the sensitivity of the PPE from 2.5-6% to 50-95%. Overall sensitivity appears to be about 50%; false-positive rates can be as high as 40%, and there is at least a 4-5% false-negative rate. In Europe, ECG-based screening programs have been associated with a decline in the SCD rate in young athletes, but similar programs are currently not recommended in the United States for many reasons: lack of randomized trial data; cost of screening; lack of a clear standard for ECG interpretation in the athlete; the likelihood that asymptomati...Continue Reading

References

Jul 1, 1976·Circulation·R B DevereuxM E Josephson
Jul 11, 1992·Journal of the American College of Cardiology·G W DecI Palacios
Oct 1, 1987·Annals of Surgery·K J TveterR L Varco
Nov 21, 1985·The New England Journal of Medicine·R A NishimuraA J Tajik
Jan 1, 1980·Acta Medica Scandinavica·J KarjalainenJ Heikkilä
Oct 6, 1997·Medicine and Science in Sports and Exercise·C M FullerG H Whipple
Oct 16, 1999·British Journal of Sports Medicine·S SharmaW J McKenna
May 5, 2000·Medicine and Science in Sports and Exercise·C M Fuller
Oct 20, 2000·Medicine·L Le ClaincheJ De Blic
May 22, 2002·Circulation·Paolo AngeliniScott Flamm
Jul 27, 2002·Journal of the American College of Cardiology·Alessandro BiffiBarry J Maron
Nov 13, 2002·Circulation·Stefan MöhlenkampRaimund Erbel
Sep 12, 2003·The New England Journal of Medicine·Barry J Maron
Dec 8, 2004·Annals of Internal Medicine·Robert E EckartRenu Virmani
Apr 20, 2005·Journal of the American College of Cardiology·Barry J Maron, Douglas P Zipes
Nov 17, 2005·Heart·David F Dickinson
Jan 6, 2006·Medicine and Science in Sports and Exercise·Yuji TanakaKatsura Arima
May 5, 2006·Medicine and Science in Sports and Exercise·Athanasios KapetanopoulosPaul D Thompson
Jul 19, 2006·Cardiology·I HatzarasJ A Elefteriades
Oct 5, 2006·JAMA : the Journal of the American Medical Association·Domenico CorradoGaetano Thiene
Oct 5, 2006·JAMA : the Journal of the American Medical Association·Paul D Thompson, Benjamin D Levine
Oct 14, 2006·Pacing and Clinical Electrophysiology : PACE·Charles Antzelevitch
Dec 5, 2006·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Karin BilleErik J Meijboom

❮ Previous
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Citations

Mar 3, 2010·Annals of Internal Medicine·Matthew T WheelerEuan A Ashley
May 8, 2010·Journal of Athletic Training·Daniel P O'Connor, Mark A Knoblauch
Feb 2, 2012·The Physician and Sportsmedicine·Nabeel Sheikh, Sanjay Sharma
Jan 6, 2010·The Physician and Sportsmedicine·Christine E Lawless
Aug 21, 2015·Pediatric Cardiology·Laure LégerYvan Mivelaz
Oct 30, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Richard KobzaPaul Erne
Mar 6, 2012·Progress in Cardiovascular Diseases·Jeffrey L Hastings, Benjamin D Levine
Jul 9, 2010·Clinics in Sports Medicine·Marc A ChildressBenjamin D Levine
Mar 12, 2011·Journal of the American College of Cardiology·Alfred A Bove
Sep 11, 2009·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Francis G O'ConnorRalph G Oriscello
Feb 7, 2012·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·Choon Ta NgChi Keong Ching
Apr 14, 2011·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·Choon Ta NgHean Yee Ong
Nov 10, 2009·The Journal of School Nursing : the Official Publication of the National Association of School Nurses·Kim Subasic
Apr 1, 2011·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Arend MosterdPeter Engelfriet
Sep 4, 2009·The American Journal of Sports Medicine·Bruce Reider
Sep 17, 2014·Circulation·Barry J MaronUNKNOWN American Heart Association Council on Clinical Cardiology, Advocacy Coordinating Committee, Council on Cardiovascular Diseas
Sep 11, 2009·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Arne LjungqvistChristophe Dubi
Jan 6, 2010·The Physician and Sportsmedicine·John P Higgins
Sep 6, 2013·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Magnus Thue StokstadKnut Gjesdal
May 31, 2011·Current Sports Medicine Reports·Sarina K BeheraAnthony Luke
Feb 2, 2013·Current Opinion in Cardiology·Victoria L Vetter, Noreen P Dugan
Mar 3, 2020·The Pan African Medical Journal·Désiré Alain AffanglaAbdoul Kane

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