International criteria for electrocardiographic interpretation in athletes: Consensus statement

Area of Science:

• Sports Cardiology
• Cardiovascular Health in Athletes
• Electrocardiography

Background:

• Sudden cardiac death (SCD) is a primary cause of mortality in athletes during sports.
• Many SCD cases in young athletes stem from hereditary cardiac disorders detectable by electrocardiograms (ECGs).
• Limited physician expertise in ECG interpretation hinders its application in athlete cardiovascular care.

Purpose of the Study:

• To update contemporary standards for ECG interpretation in athletes.
• To define and revise ECG interpretation criteria based on new research.
• To provide a guide for evaluating ECG abnormalities in athletes and linking them to SCD risk.

Main Methods:

• An international expert consensus meeting was convened in Seattle, USA.
• Experts in sports cardiology, inherited cardiac disease, and sports medicine reviewed emerging research.
• Standards for ECG interpretation in athletes were updated based on scientific data and investigations.

Main Results:

• New evidence and refined criteria for ECG interpretation in athletes were established.
• Distinctions between normal physiological adaptations and abnormal findings suggestive of pathology were clarified.
• Recommendations were developed linking specific ECG abnormalities to secondary evaluations for SCD-associated conditions.

Conclusions:

• Physicians require updated knowledge of ECG interpretation to manage athlete cardiovascular health effectively.
• This international consensus provides expert-opinion-based recommendations for ECG interpretation in athletes.
• The updated standards aim to improve the identification of athletes at risk for SCD.