Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes

Riding, Nathan R; Sheikh, Nabeel; Adamuz, Carmen; Watt, Victoria; Farooq, Abdulaziz; Whyte, Gregory; George, Keith; Drezner, Jonathan A.; Sharma, Sanjay; Wilson, Mathew G

doi:10.1136/heartjnl-2014-306437

Cited by 105 publications

(107 citation statements)

References 22 publications

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“…By using the Seattle criteria, we achieved a 2.5-fold reduction in the occurrence of pathological changes in comparison to ESC criteria, whereas Refined criteria gave a nearly four-fold reduction in comparison to the ESC criteria. Riding et al [22], in an extensive analysis (2.491 male athletes, different nationalities, different disciplines), obtained very similar results: ESC criteria vs. Seattle criteria revealed an almost 2-fold reduction, and ESC criteria vs. Refined criteria a 4-fold reduction in detection of abnormal changes.…”

Section: Discussionsupporting

confidence: 55%

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The differences in electrocardiogram interpretation in top-level athletes

et al. 2017

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A b s t r a c tBackground: The Ministry of Health in Poland recommends electrocardiogram (ECG)-based cardiovascular screening in athletes, but so far there has been a lack of guidelines on preparticipation assessment. We compared different criteria of ECG screening assessment in a group of top-level athletes. Aim:The aims were to evaluate the prevalence of ECG changes in athletes that necessitate further cardiological work-up according to three criteria in various age groups as well as to identify factors determining the occurrence of changes related and unrelated to the training.Methods: 262 high-dynamic, high-static Polish athletes (rowers, cyclists, canoeists) were divided into two age categories: young (≤ 18 years of age; n = 177, mean age 16.9 ± 0.8; 15-18 years) and elite (> 18 years of age; n = 85, mean age 22.9 ± 3.4; 19-34 years). All sports persons had a 12-lead ECG performed and evaluated according to 2010 European Society of Cardiology (ESC) recommendations, 2012 Seattle criteria, and 2014 Refined criteria. Results:The Refined criteria reduced (p < 0.001) the number of training-unrelated ECG findings to 8.0% vs. 12.6% (Seattle criteria) and 30.5% (ESC recommendations). All three criteria revealed more training-related changes in the group of older athletes (76.5% vs. 55.9%, p = 0.001). Predictors that significantly (p < 0.005) affected the occurrence of adaptive changes were the age of the athlete, training duration (in years), and male gender.Conclusions: 1. The ESC criteria identified a group of athletes that was unacceptably large, as for the screening test, requiring verification with other methods (every fourth athlete). 2. The use of the Refined criteria helps to significantly reduce the frequency and necessity for additional tests. 3. The dependence of adaptive changes on training duration and athletes' age confirms the benign nature of those ECG findings.

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Section: Discussionsupporting

confidence: 55%

“…Among the 11 patients (the 10% mentioned above), seven had a family history of HCM, and four presented a systolic cardiac murmur. Similarly, Riding et al [22] showed in his paper that heart auscultation helped to identify an additional 1.2% (n = 29) of athletes with valvular heart disease, who did not present pathological changes in ECG.…”

Section: Discussionmentioning

confidence: 99%

The differences in electrocardiogram interpretation in top-level athletes

et al. 2017

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“…The frequency of abnormal ECG readings have decreased with the use of each criteria: European Cardiology Society 22%, Seattle Criteria 11.6%, Refined Criteria 5.3%. 9 This demonstrates that Refined Criteria has had the most success in decreasing false positives in ECG interpretation by combining the most effective aspects of each criteria system and by standardizing interpretation techniques.…”

Section: Introductionmentioning

confidence: 92%

ECG measurement parameters of athletes are reliable when made with a smartphone based ECG device

Gilliland¹,

Timmons²,

Harris³

et al. 2018

MJM

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Petrany, Stephen M.; Shepherd, Terry A.; Buchanan, Grant S.; Decker, Nicole; and Giangarra, Charles (2018) "ECG measurement parameters of athletes are reliable when made with a smartphone based ECG device," Marshall Journal of Medicine: Vol. 4: Iss. 2, Article 7. DOI: http://dx.doi.org/10. 18590/mjm.2018.vol4.iss2.7 Available at: http://mds.marshall.edu/mjm/vol4/iss2/7References with DOI 1. 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. 2009119(8) (8) AbstractAthletic pre-participation cardiac screening including electrocardiogram (ECG) is a subject of controversy among sports medicine practitioners. Opponents of pre-participation ECG screening cite concerns regarding the cost and accuracy of the testing. Recently, a single lead ECG accessory has become available for use with smartphones. The purpose of this study was to evaluate the between and within rater validity and reliability of the Kardia device in recording the ECG parameters rate, rhythm, and PR, QRS, QT intervals. The ECG parameters recorded with the smartphone were also compared to same measures made using a 12 lead electrocardiograph.This investigation used a repeated measures cross-sectional design. The investigation was conducted in two separate phases using separate participant samples. Phase 1 (N=10) was used to determine the within rater reliability with the Kardia device. Phase 2 (N=12) was used to determine the reliability between the Kardia device and the 12 lead electrocardiograph.The between rater and between device reliability for the rate, QT interval and QRS duration parameters ranged good to very good (ICC = 0.667 -0.981). The current investigation showed that the reliability of the ECG parameters measured using the smartphone technology ranged from good to very good. This paper serves as support for a technological advancement that will help advance the debate on the utility of ECG testing as part of the athletic pre-participation physical.

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“…118 Various coding systems have been developed in efforts to optimize the utility of the ECG in this screening function. 119,120 Cost-effectiveness studies of screening in asymptomatic youth have been performed, with selected results presented below. (Table 2).…”

Section: Identification Of Young Patients At Risk For Scd Prodromal Smentioning

confidence: 99%

Sudden cardiac death in the young

2017

Progress in Pediatric Cardiology

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Although the occurrence of sudden cardiac death (SCD) in a young person is a rare event, it is traumatic and often widely publicized. In recent years, SCD in this population has been increasingly seen as a public health and safety issue. This review presents current knowledge relevant to the epidemiology of SCD and to strategies for prevention, resuscitation and identification of those at greatest risk. Areas of active research and controversy include the development of best practices in screening, risk stratification approaches and post-mortem evaluation, and identification of modifiable barriers to providing better outcomes after resuscitation of young SCD victims. Institution of a national registry of SCD in the young will provide data that will help to answer these questions.

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Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes

Cited by 105 publications

References 22 publications

The differences in electrocardiogram interpretation in top-level athletes

The differences in electrocardiogram interpretation in top-level athletes

ECG measurement parameters of athletes are reliable when made with a smartphone based ECG device

Sudden cardiac death in the young

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