Visual or computer-based measurements: important for interpretation of athletes' ECG.

Area of Science:

• Sports Medicine
• Cardiology
• Medical Diagnostics

Background:

• Electrocardiograms (ECGs) are crucial for preparticipation health evaluations in athletes.
• Current interpretation guidelines lack consensus, leading to varied abnormality criteria.

Purpose of the Study:

• To compare the prevalence of abnormal ECG findings between visual and computer-based measurement methods.
• To assess the correlation between visual and computer-based ECG measurements in athletes.

Main Methods:

• ECGs from 595 male professional soccer players (aged 18-38) were analyzed.
• Interpretations followed European Society of Cardiology (ESC) and Seattle criteria using visual and computer-based methods.
• Statistical analysis included kappa (κ) statistics and intraclass correlation.

Main Results:

• Abnormal ECGs were identified in 29.5% (ESC) vs 11.1% (Seattle) visually, and 50.6% (ESC) vs 21.9% (Seattle) by computer.
• Computer-based measurements yielded significantly higher abnormality rates.
• High correlation was observed for wave amplitudes and moderate to very good for intervals and T wave inversions.

Conclusions:

• Computer-based ECG analysis reveals a substantially higher prevalence of abnormalities than visual assessment.
• Discrepancies in measurement methods significantly impact athlete screening outcomes and the need for further cardiac evaluations.
• Standardization of ECG interpretation reference values based on measurement methodology is recommended.