ECG interpretation for pre-participation screening in athletes

Area of Science:

• Cardiology
• Sports Medicine
• Preventive Cardiology

Background:

• The use of electrocardiography (ECG) in pre-participation screening (PPS) for athletes is debated.
• Growing evidence highlights ECG's role in identifying cardiovascular diseases linked to sudden cardiac death (SCD).
• Systematic ECG screening has demonstrably reduced SCD incidence in athletic populations.

Purpose of the Study:

• To review the evolution and current application of ECG interpretation standards in athletic PPS.
• To discuss the challenges and necessary adaptations of current criteria for diverse athlete populations.
• To emphasize the importance of refining ECG criteria for improved SCD prevention.

Main Methods:

• Review of the literature on ECG interpretation in athletic populations.
• Analysis of the development and impact of the International Criteria for ECG interpretation.
• Discussion of physiological variants, borderline findings, and abnormal patterns in athlete ECGs.

Main Results:

• The International Criteria provide a framework for classifying ECG findings (normal, borderline, abnormal).
• Training- and vagal tone-related changes are recognized as physiological.
• Borderline findings require careful interpretation, while abnormal patterns necessitate further investigation.

Conclusions:

• ECG is crucial for detecting conditions that cause SCD in athletes.
• Current International Criteria need refinement to address special populations like children, women, and master athletes.
• Future updates to ECG criteria are essential for enhancing diagnostic accuracy and preventing SCD.