Prevalence and electrocardiographic characteristics of early repolarization pattern in young teen athletes

Early repolarization (ERP) is a common electrocardiographic finding. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest.

122 subjects (100% males; mean age: 13.5 +/- 2.7 years) were included from a local youth soccer team in Belgium. All subjects underwent physical examination and a 12-lead ECG was taken. The main objective of the study was to evaluate early repolarization patterns and to determine its prevalence.

Of the 122 included subjects, 1 subject with Coumel tachycardia was excluded.The overall prevalence of ERP in our study population was 36%, with 9.1% in the inferior leads, 8.2% in the lateral leads and 18.2% both leads. A family history of sudden cardiac death (SCD) was not higher in the group of ERP (N=3; 6.8%) compared to the non-ERP group (N = 4; 5.2%) (P = 0.713). Interestingly, incomplete right bundle-branch block (IRBBB) was significantly lower among all subjects with ERP (N = 15; 34.1%), compared to those without ERP (N = 49; 63%) (P < 0.002).

ERP is a common finding in young teen athletes. In this population global ERP (both inferior and lateral) is more common than isolated inferior or lateral ERP. Young age might be a contributing factor in causing a more diffuse repolarization abnormality.