Author + information
- Christine E. Lawless,
- Lonnie Albers,
- David Marx,
- Lori Heiss,
- Mathue Baker,
- Todd Tessendorf and
- Steven Krueger
Lack of a systematic approach to athlete ECG interpretation may lead to unnecessary cardiac testing (CT) in athletes undergoing pre–participation ECG screening. Updated interpretation criteria (2011 IC) may reduce need for further CT, but data is limited in USA athletes, and financial impact to athletic departments uncertain.
For 10 years, our institution has performed screening ECGs in all incoming NCAA athletes. To determine rate at which 2011 IC would prompt further CT, we analyzed 494 consecutive athlete ECGs using 2011 IC. Demographics: age 18.9 ± 1.2 yrs, 64.8% male, 76.3% White, 13.8% Black, 2.3% Hispanic, 2.3% Asian, and 5.2% other; sports 29.6% track, 12.9% football, 11.7%, baseball, 7.7% wrestling, 6.2%, swimming, 6% basketball, and 25.9% other.
2011 IC were met if any one of 11 individual IC were present (10.7% overall positive for IC; 4.2% inverted T waves; 2.8% atrial abnormalities,1.6% significant Q waves; 1.6% QRS axis <–30 or >115; 0.8% QRS duration >120 msec; 0.2% right ventricular hypertrophy; 0.6% ST depression; 0.4% long QTc; 0.2% PVCs; none with pre–excitation or Brugada pattern.
Characteristic gender differences in ECG intervals were noted. Application of updated 2011 IC resulted in 10.7% of ECGs that would have prompted a need for further CT, due to T waves, atrial abnormalities, Q waves and axis deviations. This figure, although improved from prior rates, suggests athlete 2011 IC may require continued refinement in collegiate athletes.
|Ethnicity (% Black)||16.8||8.9||ns|
|Heart rate (BPM)||62.5±10.1||65.0±11.8||0.0179|
|QRS duration (msec)||95.3±9.3||88.1±9.1||<.0001|
|% meeting updated ECG IC||10.63||10.92||ns|
South, Room 102
Sunday, March 10, 2013, 10:45 a.m.–11:00 a.m.
Session Title: Evaluating the Athlete's Heart: Emerging Science
Abstract Category: 30. Sports and Exercise Cardiology: Sports Medicine
Presentation Number: 930–3
- 2013 American College of Cardiology Foundation