Skip to main content
Top
Published in: Netherlands Heart Journal 3/2018

Open Access 01-03-2018 | Point of View

A new consensus document on electrocardiographic interpretation in athletes: does it help to prevent sudden cardiac death in athletes?

Authors: N. M. Panhuyzen-Goedkoop, H. T. Jørstad, J. L. R. M. Smeets

Published in: Netherlands Heart Journal | Issue 3/2018

Login to get access

Abstract

Sudden cardiac arrest or death (SCA/SCD) in athletes has a low event rate. Pre-participation or eligibility screening is a widely accepted method of primary prevention of SCA/SCD in athletes. Most European countries and international sports governing bodies perform ECG-inclusive screening. However, implementation of a resting 12-lead ECG in pre-participation or eligibility cardiac screening is still a topic of debate. Recently, the ‘International recommendations for electrocardiographic interpretation in athletes’ was published in three leading international medical journals. These international ECG criteria are based on studies with detailed information on resting 12-lead ECG of Caucasian and Afro-Caribbean athletes or on consensus in case evidence was lacking. Normal, borderline and abnormal ECG findings in young athletes (age 12–35 years) are clearly described and illustrated to assist the screening physician in interpreting ECGs of athletes correctly.
In this ‘point of view paper’ we will discuss whether these new ECG criteria actually help prevent SCA/SCD in athletes.
Literature
1.
go back to reference Bille K, Figuerias D, Schamasch P, et al. Sudden cardiac death in athletes: the Lausanne recommendations. Eur J Cardiovasc Prev Rehabil. 2006;13:859–75.CrossRefPubMed Bille K, Figuerias D, Schamasch P, et al. Sudden cardiac death in athletes: the Lausanne recommendations. Eur J Cardiovasc Prev Rehabil. 2006;13:859–75.CrossRefPubMed
2.
go back to reference Corrado D, Basso C, Pavei A, et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a pre-participation screening program. J Am Med Assoc. 2006;296:1593–601.CrossRef Corrado D, Basso C, Pavei A, et al. Trends in sudden cardiovascular death in young competitive athletes after implementation of a pre-participation screening program. J Am Med Assoc. 2006;296:1593–601.CrossRef
3.
go back to reference Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119:1085–92.CrossRefPubMed Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119:1085–92.CrossRefPubMed
4.
go back to reference Baggish AL, Hutter AM Jr, Wang F, et al. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med. 2010;152:269.CrossRefPubMed Baggish AL, Hutter AM Jr, Wang F, et al. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med. 2010;152:269.CrossRefPubMed
5.
go back to reference Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, etiology, and comparative frequency of sudden cardiac death in NCAA athletes: a decade in review. Circulation. 2015;132:10–9.CrossRefPubMedPubMedCentral Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, etiology, and comparative frequency of sudden cardiac death in NCAA athletes: a decade in review. Circulation. 2015;132:10–9.CrossRefPubMedPubMedCentral
6.
go back to reference Risgaard B. Sudden cardiac death: a nationwide cohort study among the young. Dan Med J. 2016;B5321:63. Risgaard B. Sudden cardiac death: a nationwide cohort study among the young. Dan Med J. 2016;B5321:63.
7.
go back to reference Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81:1479–87.CrossRefPubMed Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81:1479–87.CrossRefPubMed
8.
go back to reference Corrado D, Pelliccia A, Bjornstad HH, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26:516–24.CrossRefPubMed Corrado D, Pelliccia A, Bjornstad HH, et al. Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol. Consensus Statement of the Study Group of Sport Cardiology of the working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2005;26:516–24.CrossRefPubMed
9.
go back to reference Maron BJ, Levine BD, Washington RL, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 2: pre-participation screening for cardiovascular disease in competitive athletes. Circulation. 2015;132:e267–e72.CrossRefPubMed Maron BJ, Levine BD, Washington RL, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 2: pre-participation screening for cardiovascular disease in competitive athletes. Circulation. 2015;132:e267–e72.CrossRefPubMed
10.
go back to reference Drezner JA, O’Connor FG, Harmon KG, et al. AMSSM Position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions. Br J Sports Med. 2016;51:153–67. Drezner JA, O’Connor FG, Harmon KG, et al. AMSSM Position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions. Br J Sports Med. 2016;51:153–67.
11.
go back to reference Drezner J, Harmon K, Heistand J, et al. Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation. 2009;120:518–25.CrossRefPubMed Drezner J, Harmon K, Heistand J, et al. Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibrillators. Circulation. 2009;120:518–25.CrossRefPubMed
12.
go back to reference Sharma S, Drezner JA, Baggish A, et al. International recommendations for electrocardiographic interpretation in athletes. J Am Coll Cardiol. 2017;69:1057–75.CrossRefPubMed Sharma S, Drezner JA, Baggish A, et al. International recommendations for electrocardiographic interpretation in athletes. J Am Coll Cardiol. 2017;69:1057–75.CrossRefPubMed
14.
go back to reference Drezner JA, Sharma S, Baggish A, et al. International recommendations for electrocardiographic interpretation in athletes. Br J Sports Med. 2017;51:704–31.CrossRefPubMed Drezner JA, Sharma S, Baggish A, et al. International recommendations for electrocardiographic interpretation in athletes. Br J Sports Med. 2017;51:704–31.CrossRefPubMed
15.
go back to reference Panhuyzen-Goedkoop NM, Hoogsteen J. Pre-participation cardiovascular screening in young athletes in the Netherlands. Neth Heart J. 2005;13:335–7.PubMedPubMedCentral Panhuyzen-Goedkoop NM, Hoogsteen J. Pre-participation cardiovascular screening in young athletes in the Netherlands. Neth Heart J. 2005;13:335–7.PubMedPubMedCentral
16.
go back to reference Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J. 2010;31:243–59.CrossRefPubMed Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J. 2010;31:243–59.CrossRefPubMed
17.
go back to reference Pelliccia A, Fagard R, Bjornstad HH, et al. Recommendations for competitive sports participation in athletes with CV disease. Eur Heart J. 2005;26:1422–45.CrossRefPubMed Pelliccia A, Fagard R, Bjornstad HH, et al. Recommendations for competitive sports participation in athletes with CV disease. Eur Heart J. 2005;26:1422–45.CrossRefPubMed
18.
go back to reference Heidbuchel H, Papadakis M, Panhuyzen-Goedkoop N, et al. Position paper: proposal for a core curriculum for a European sports cardiology qualification. Eur J Prev Cardiol. 2013;20:889–903.CrossRefPubMed Heidbuchel H, Papadakis M, Panhuyzen-Goedkoop N, et al. Position paper: proposal for a core curriculum for a European sports cardiology qualification. Eur J Prev Cardiol. 2013;20:889–903.CrossRefPubMed
19.
go back to reference Rawlins J, Carre F, Kervio G, et al. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation. 2010;121:1078–85.CrossRefPubMed Rawlins J, Carre F, Kervio G, et al. Ethnic differences in physiological cardiac adaptation to intense physical exercise in highly trained female athletes. Circulation. 2010;121:1078–85.CrossRefPubMed
20.
go back to reference Sheikh N, Papadakis M, Ghani S, et al. Comparison of electrocardiographic criteria for the detection of cardiac abnormalities in elite black and white athletes. Circulation. 2014;129:1637–49.CrossRefPubMed Sheikh N, Papadakis M, Ghani S, et al. Comparison of electrocardiographic criteria for the detection of cardiac abnormalities in elite black and white athletes. Circulation. 2014;129:1637–49.CrossRefPubMed
21.
go back to reference Riding NR, Sheikh N, Adamuz C, et al. Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes. Heart. 2014;101:384–90.CrossRefPubMedPubMedCentral Riding NR, Sheikh N, Adamuz C, et al. Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes. Heart. 2014;101:384–90.CrossRefPubMedPubMedCentral
22.
go back to reference Malhotra A, Walker M, Dhutia H, et al. Pre-participation screening in adolescent athletes: a comparison of European Society of Cardiology, Seattle and Refined ECG criteria: which is best? Heart. 2015;101:A45. Malhotra A, Walker M, Dhutia H, et al. Pre-participation screening in adolescent athletes: a comparison of European Society of Cardiology, Seattle and Refined ECG criteria: which is best? Heart. 2015;101:A45.
23.
go back to reference Drezner JA, Ackerman MJ, Anderson J, et al. Electrocardiographic interpretation in athletes: the Seattle criteria. Br J Sports Med. 2013;47:122–4.CrossRefPubMed Drezner JA, Ackerman MJ, Anderson J, et al. Electrocardiographic interpretation in athletes: the Seattle criteria. Br J Sports Med. 2013;47:122–4.CrossRefPubMed
24.
go back to reference Drezner JA, Fischbach P, Froelicher V, et al. Normal electrocardiographic findings: recognizing physiological adaptations in athletes. Br J Sports Med. 2013;47:125–36.CrossRefPubMed Drezner JA, Fischbach P, Froelicher V, et al. Normal electrocardiographic findings: recognizing physiological adaptations in athletes. Br J Sports Med. 2013;47:125–36.CrossRefPubMed
25.
go back to reference Drezner JA, Ashley E, Baggish AL, et al. Abnormal electrocardiographic findings in athletes: recognizing changes suggestive of cardiomyopathy. Br J Sports Med. 2013;47:137–52.CrossRefPubMed Drezner JA, Ashley E, Baggish AL, et al. Abnormal electrocardiographic findings in athletes: recognizing changes suggestive of cardiomyopathy. Br J Sports Med. 2013;47:137–52.CrossRefPubMed
26.
go back to reference Sheikh N, Papadakis M, Carre F, et al. Cardiac adaptation to exercise in adolescent athletes of African ethnicity: an emergent elite athletic population. Br J Sports Med. 2013;47:585–92.CrossRefPubMed Sheikh N, Papadakis M, Carre F, et al. Cardiac adaptation to exercise in adolescent athletes of African ethnicity: an emergent elite athletic population. Br J Sports Med. 2013;47:585–92.CrossRefPubMed
27.
go back to reference Duhtia H, Malhotra A, Gabus V, et al. Cost implications of using different ECG criteria for screening young athletes in the United Kingdom. J Am Coll Cardiol. 2016;16:702–11.CrossRef Duhtia H, Malhotra A, Gabus V, et al. Cost implications of using different ECG criteria for screening young athletes in the United Kingdom. J Am Coll Cardiol. 2016;16:702–11.CrossRef
28.
go back to reference Panhuyzen-Goedkoop NM, Smeets JLRM. Legal responsibilities of physicians when making participation decisions in athletes with cardiac disorders: do guidelines provide a solid legal footing? Br J Sports Med. 2014;48:1193–5.CrossRefPubMed Panhuyzen-Goedkoop NM, Smeets JLRM. Legal responsibilities of physicians when making participation decisions in athletes with cardiac disorders: do guidelines provide a solid legal footing? Br J Sports Med. 2014;48:1193–5.CrossRefPubMed
29.
go back to reference Mitten MJ, Zipes DP, Maron BJ, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 15: legal aspects of medical eligibility and disqualification recommendations. Circulation. 2015;132:e346–e9.CrossRefPubMed Mitten MJ, Zipes DP, Maron BJ, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 15: legal aspects of medical eligibility and disqualification recommendations. Circulation. 2015;132:e346–e9.CrossRefPubMed
30.
go back to reference Weiner RB, Hutter AM, Wang F, et al. Performance of the 2010 European Society of Cardiology criteria for ECG interpretation in the athlete. Heart. 2011;97:1573–7.CrossRefPubMed Weiner RB, Hutter AM, Wang F, et al. Performance of the 2010 European Society of Cardiology criteria for ECG interpretation in the athlete. Heart. 2011;97:1573–7.CrossRefPubMed
Metadata
Title
A new consensus document on electrocardiographic interpretation in athletes: does it help to prevent sudden cardiac death in athletes?
Authors
N. M. Panhuyzen-Goedkoop
H. T. Jørstad
J. L. R. M. Smeets
Publication date
01-03-2018
Publisher
Bohn Stafleu van Loghum
Published in
Netherlands Heart Journal / Issue 3/2018
Print ISSN: 1568-5888
Electronic ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-018-1076-6

Other articles of this Issue 3/2018

Netherlands Heart Journal 3/2018 Go to the issue