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George, KP and Whyte, G (2015) Comparison of three current sets of electrocardiographic interpretation criteria for use in screening athletes. Heart, 101 (5). pp. 384-393. ISSN 1468-201X
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Abstract
BACKGROUND: An increasing number of sporting bodies report unacceptably high levels of false positive electrocardiograms (ECGs) when undertaking pre-participation cardiac screening. To address this issue, modified ECG interpretation criteria have become available for use within athletes. OBJECTIVE: This study assessed the accuracy of the new 2014 ‘Refined Criteria’ against the 2013 Seattle Criteria and the 2010 European Society of Cardiology (ESC) recommendations in a cohort of Arabic, Black and Caucasian athletes. METHODS: 2491 male athletes (1367 Arabic, 748 Black and 376 Caucasian) undertook pre-participation screening including a 12-Lead ECG; with further investigation(s) upon indication. RESULTS: Ten athletes (0.4%) were identified with cardiac pathology; 7 with hypertrophic cardiomyopathy (HCM; 5 Black and 2 Arabic) and 3 Arabs with Wolff-Parkinson-White syndrome (WPW). All 3 ECG criteria were 100% sensitive identifying all cases of HCM and WPW. The 2014 Refined Criteria reduced (p<0.0001) the prevalence of an abnormal ECG to 5.3% vs. 11.6% (Seattle Criteria) and 22.3% (2010 ESC recommendations). The 2014 Refined Criteria significantly (p<0.0001) improved specificity (94.0%) across all ethnicities compared to the Seattle Criteria (87.5%) and ESC recommendations (76.6%). Black athletes continue to present a higher prevalence (p<0.0001) of abnormal ECGs compared to Arabic and Caucasian athletes (10% vs. 3.6% and 2.1%). CONCLUSION: The 2014 Refined Criteria for athlete ECG interpretation outperformed both the 2013 Seattle Criteria and the 2010 ESC recommendations by significantly reducing the number of false-positive ECGs in Arabic, Black and Caucasian athletes whilst maintaining 100% sensitivity for serious cardiac pathologies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 1102 Cardiovascular Medicine And Haematology |
| Subjects: | R Medicine > RC Internal medicine > RC1200 Sports Medicine |
| Divisions: | Sport and Exercise Sciences |
| Publisher: | BMJ Publishing Group |
| Date Deposited: | 07 Mar 2017 12:14 |
| Last Modified: | 04 Sep 2021 12:41 |
| DOI or ID number: | 10.1136/heartjnl-2014-306437 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/3910 |
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