Modern standards of ECG interpretation in young athletes: Yield and effectiveness

Asif, Irfan M.; Prutkin, Jordan M.

doi:10.1016/j.jelectrocard.2014.12.017

Cited by 6 publications

(5 citation statements)

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“…The need to adapt the criteria to the population studied (in terms of race, demographics, type of sport) has become a new direction in the study of athletes [15]. The problem was raised by Asif and Prutkin [16] and Prakash and Sharma [17], who ascertained that individualisation of study criteria is the key and the right direction to improve screening with the view of minimising the false positive results and unnecessary disqualification of athletes. The sensitivity of ECG-based screening is unquestionable.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

The differences in electrocardiogram interpretation in top-level athletes

et al. 2017

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“…25 Subsequently, the development of screening-specific interpretation criteria for athlete ECG has decreased false positive rates and increased cost-effectiveness. [26][27][28] By adding a screening ECG with an incremental cost of $89 per participant, it is estimated to save 2.06 life-years per 1000 participants with a costeffectiveness ratio of $42 900 per life-year. 29 ECG is recognized to have a high negative predictive value, but false negative rates can range from 4% to 5%.…”

Section: Use Of Electrocardiogram In Screeningsmentioning

confidence: 99%

Cardiovascular Ultrasound Combined With Non-invasive Screening for the Detection of Undiagnosed Cardiovascular Disease: A Literature Review

Bierig

Arnold

Einbinder³

et al. 2017

Journal of Diagnostic Medical Sonography

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Non-invasive screenings have been widely utilized in the United States and worldwide to provide early identification of cardiovascular disease, allowing for earlier diagnosis and treatment. Screening sonography detects valve disease, cardiac dysfunction, and carotid disease in 5% to 20% of the population. This review discusses the current data regarding cardiovascular screening, the methodologies, and the resources required for performance of screenings. Cardiac and carotid sonography is highly accurate and discovers cardiovascular diseases that impact quality of life and risk of future events. Screenings are performed in a variety of settings and accuracy depends on the quality of personnel performing the non-invasive testing, the equipment utilized, and the personnel interpreting the studies. Despite the potential benefit for disease detection, population screening to detect cardiovascular disease is not widely supported by national organizations due to the theoretical cost of further testing and lack of cost versus benefit data. Additional studies are necessary to compare costs and benefits of non-invasive cardiovascular screening in the community setting.

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“…Criteria need to be further refined based on age, sex, ethnicity, and sport. 6 A study by Hill et al presents another reason why mass prescreening ECGs may not be a good idea. 7 The study evaluated the accuracy of pediatric cardiologists' interpretations of ECGs demonstrating abnormal findings that might indicate an underlying disease, which could lead to sudden, unexpected death in an athlete.…”

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confidence: 99%

“…Fine needle aspiration, though, remains the most accurate modality for diagnosing thyroid malignancies preoperatively. 1,4,6,7 A total of 241 children referred for evaluation of thyroid nodules were included in this report, and of these children, 189 comprised the study group. 5 Evaluation of ultrasound findings, fine needle aspiration results, along with surgical pathology were used to assess the sensitivity and specificity of imaging characteristics as predictors of cancer.…”

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confidence: 99%

“…These data strongly support the role of ultrasonography as an essential screening tool for children with thyroid nodules and are in concert with studies involving adults and children. 1,4,6,7 However, Mussa et al joins other studies that reveal limitations with the use of ultrasonography alone in establishing a diagnosis of cancer. 1,4,6,7 The report by Mussa et al is also laden with important clinical caveats.…”

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confidence: 99%

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