Effects of International Electrocardiographic Interpretation Recommendations on African American Athletes

Abstract

Young athletes regularly push themselves to the limit for college, club, or country; they are role models for many. Therefore, the death of such individuals has a profound and lasting effect on the community. Most athlete deaths are due to inherited or congenital abnormalities of the heart, including cardiomyopathies, disorders involving accessory pathways, and ion channel diseases, which are detectable during life. The American Heart Association and the European Society of Cardiology support early detection of affected athletes on the premise that several interventions are available to modify the natural history of many of these diseases and thereby prevent sudden death. Despite the debate surrounding best cardiovascular screening practice, inclusion of electrocardiograms (ECGs) increases the sensitivity of detection for cardiomyopathy and electrical diseases. 1 For this reason, ECGs are incorporated into the cardiac assessments of most elite athletes in Europe and North America.

The Impact of Ethnicity on Cardiac Adaptation

“…Nevertheless the false-positive rate in black athletes remains relatively high, despite the increased specificity (97%) compared to the ESC and Seattle criteria. 64,65 Mixed Ethnicity…”

Cardiovascular Screening before Sports Participation: Results of 11487 Children

“…11,487 children, aged 7-18 years, who were referred to the pediatric cardiology outpatient clinic for pre-sport cardiac evaluation were determined. Of the subjects, 6287 (54.7 %) were male and 5200 (45.2 %) were female, and the mean age was 12.7 ± 4.57 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years. The average age of the female patients was 11.1 ± 3.64 years, while the average age of the male subjects was 13.9 ± 4.17 years.…”

“…Participants with abnormal history, physical examination, ECG (extrasystoles: ventricular or supraventricular) , and echocardiography underwent further studies like 24-hour rhythm Holter analysis (Rising MedModel CV-3U; DM Software Inc., Beijing, China), and EST (Cardioline Series Cubestress Trolley MP; Cavareno (TN), Italy) [10,11]. When other congenital cardiac heart defects, coronary abnormalities, or cardiomyopathy were suspected, advanced diagnostic work-up like magnetic resonance imaging (MRI), and angiography were arranged.…”

“…Ergebnisse Insgesamt wurden 11 487 Kinder an die kardiologische Ambulanz zum Screening vor Teilnahme an sportlichen Aktivitäten überwiesen. Das Durchschnittsalter betrug 12,7 ± 4,57 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Jahre. Zunächst erhielten 34/11 487(0,29 %) der Untersuchten keine Erlaubnis zur Teilnahmen an sportlichen Introduction Sudden cardiac arrest (SCA) and sudden cardiac death (SCD) during sports are extremely rare but significant tragic situations [1].…”

“…For the distinctive threshold method, the point where the differential waveform of the T wave returns to the background level is identified as the T-wave terminus, and its distance from the start of the QRS complex is calculated [9]. block, complete (QRS duration longer than 120 milisecond (msn)/ incomplete (QRS durations between 100-119 msn) right and left bundle block, and all ECG findings were interpreted according to the most recent international recommendations of the European Society of Cardiology and the 'Seattle' criteria [10,11]. Children with ventricular extrasystoles (VES) in more than 30 % of total heart beats in 24-hour Holter monitoring are considered to have frequent premature ectopic beats and to be at some risk of developing LV dysfunction [12].…”