Electrocardiographic changes in 1000 highly trained junior elite athletes.

Sharma, Sanjay; Whyte, Greg; Elliott, Perry; Padula, Mina; Kaushal, R.; Mahon, Niall; McKenna, William J.

doi:10.1136/bjsm.33.5.319

Cited by 246 publications

(211 citation statements)

References 28 publications

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“…However, athletes of African descent have a high incidence of isolated Twave inversion in the absence of any structural heart disease. 18,19 This ethnic variability could be the reason for the higher incidence noted in our athletes too. Isolated RBBB has also been considered as an abnormal finding among athletes.…”

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confidence: 96%

“…The high prevalence (29%) of Right Branch Block Bundle (RBBB), Right Ventricular Hypertrophy (RVH), especially associated with strain is much higher than reported too. 17,18 Not only have these features been less reported and studied, but its correlation with the type of training, reversibility and adverse effects are not known. Though the ECG features of Complete RBBB, RVH with strain and T-inversion has been considered as abnormal (because of the hypertrophy with associated T-wave inversion) it could also have resulted from the physiological cardiac adaptation of intense training leading to increased right ventricular wall thickness and cavity dilatation.…”

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confidence: 99%

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The prevalence of abnormal ECG in trained sportsmen

Malhotra

Singh

Bishnoi³

et al. 2015

Medical Journal Armed Forces India

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m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 1 ( 2 0 1 5 ) 3 2 4 -3 2(50%) were involved in a strength-training regimen. Overall 54/66 (81%) sportsmen had significant ECG changes. 68% of these changes were considered as normal training related features, while the remaining 32% were considered abnormal. There were seven common training related ECG changes-Sinus Bradycardia (21%), Sinus Arrhythmia (16%), 1st degree Atrioventricular Heart Block (6%), Type 1 2nd-degree Atrioventicular Heart Block (3%), Incomplete Right bundle branch block (RBBB) (24%), Early Repolarization (42%), Left Ventricular Hypertrophy (LVH) (14%); while three abnormal ECG changes-T-wave inversion (13%), RBBB(4%), Right ventricular hypertrophy (RVH) with strain (29%) were noted. Early repolarization (commonest change), sinus bradycardia, and incomplete RBBB were the commoner features noticed, with a significantly higher presence in the endurance trained athletes.

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confidence: 96%

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confidence: 99%

The prevalence of abnormal ECG in trained sportsmen

Malhotra

Singh

Bishnoi³

et al. 2015

Medical Journal Armed Forces India

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“…(iii) Articles about PPSP, specifically ECG or echocardiography: nine articles [41,43,45,46,48,[50][51][52][53]. We focused on the utility of the test for diagnosing underlying cardiovascular diseases, the indications for using the test, the cost-effectiveness, and the opinion of the author on the test.…”

Section: Preparticipation Screening Protocolsmentioning

confidence: 99%

“…We used the following criteria to select and group the articles relevant to our study: (i) articles describing the PPSP procedure (cardiovascular part) and using it (± reported cases; Table 2); (ii) articles describing the PPSP procedure (cardiovascular part) but not using it (no reported cases; Table 3); (iii) articles about PPSP, specifically electrocardiography (ECG) or echocardiography [ 41,43,45,46,48,[50][51][52][53]. Thirty-one articles were selected, with 11 in (i), 11 in (ii), and nine in (iii), and were analysed.…”

Section: Preparticipation Screening Protocolsmentioning

confidence: 99%

Sudden cardiac death in athletes: the Lausanne Recommendations

Bille

Figueiras

Schamasch

et al. 2006

European Journal of Cardiovascular Prevention & Rehabilitat

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Objectives This study reports on sudden cardiac death (SCD) in sport in the literature and aims at achieving a generally acceptable preparticipation screening protocol (PPSP) endorsed by the consensus meeting of the International Olympie Committee (IOC). Background The sudden death of athletes under 35 years engaged in competitive sports is a well-known occurrence; the incidence is higher in athletes ( ~ 2/1OO000 per year) than in non-athletes (2.5: 1 ), and the cause is cardiovascular in over 90%.Methods A systematic review of the literature identified causes of SCD, sex, age, underlying cardiac disease and the type of sport and PPSP in use. Methods necessary to detect pre-existing cardiac abnormalities are discussed to formulate a PPSP for the Medical Commission of the IOC.Results SCD occurred in 1101 (1966-2004) reported cases in athletes under 35 years, 50% had congenital anatomical heart disease and cardiomyopathies and 10% had early-onset atherosclerotic heart disease. Forty percent occurred in athletes un der 18 years, 33% under 16 years; the female/male ratio was 1 /9. SCD was reported in almost ail sports; most frequently involved were soccer (30%), basketball (25%) and running (15%). The PPSP were of varying quality and content. The IOC consensus meeting accepted the proposed Lausanne Recommendations based on this research and expert opinions (http://multimedia.olympic.org/pdf/en_report_886.pdf). Conclusion SCD occurs more frequently in young athletes, even those under the age of 18 years, than expected and is predominantly caused by pre-existing congenital cardiac abnormalities. Premature atherosclerotic disease forms another important cause in these young adults. A generally acceptable PPSP has been achieved by the IOC's acceptance of the Lausanne Recommendations. Eur J Cardiovasc Prev Rehabil 13:000-000

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“…Whether these physiological cardiac adaptations to repetitive strenuous training on future CVD and mortality events remain unclear in armed forces. In addition, the prevalence of ECG-derived LVH in professional military male members in the East Asian and Jewish populations was estimated 15-20% (13,14), which was much lower than that of 45% in the elite White male athletes (15).…”

Section: Introductionmentioning

confidence: 99%

A comparison of Cornell and Sokolow-Lyon electrocardiographic criteria for left ventricular hypertrophy in a military male population in Taiwan: the Cardiorespiratory fitness and HospItalization Events in armed Forces study

Su¹,

Li²,

Lin³

et al. 2017

Cardiovasc. Diagn. Ther.

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Background: The Cornell and Sokolow-Lyon electrocardiography (ECG) criteria have been widely used for diagnosing left ventricular hypertrophy (LVH) in patients with hypertension. However, the correlations of these ECG criteria with LVH were rarely compared in military members who received rigorous training, particularly of the Asian male population. Conclusions: The Cornell ECG criteria for the echocardiographic LVH had better performance than the Sokolow-Lyon criteria in a young military male cohort in Taiwan.

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Electrocardiographic changes in 1000 highly trained junior elite athletes.

Abstract: Minor T wave inversions in leads other than V2 and V3 may be present in athletes and non-athletes less than 16 but should be an indication for further investigation in older athletes. (Br J Sports Med 1999;33:319-324)

Cited by 246 publications

References 28 publications

The prevalence of abnormal ECG in trained sportsmen

The prevalence of abnormal ECG in trained sportsmen

Sudden cardiac death in athletes: the Lausanne Recommendations

A comparison of Cornell and Sokolow-Lyon electrocardiographic criteria for left ventricular hypertrophy in a military male population in Taiwan: the Cardiorespiratory fitness and HospItalization Events in armed Forces study

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