Riding, NR, Sheikh, N, Adamuz, C, Watt, V, Farooq, A, Whyte, G, George, KP, Drezner, JA, Sharma, S and Wilson, MG (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 & Exercise Sciences
Publisher:	BMJ Publishing Group
Date Deposited:	21 Aug 2020 09:45
Last Modified:	04 Sep 2021 11:49
DOI or ID number:	10.1136/heartjnl-2014-306437
URI:	https://researchonline.ljmu.ac.uk/id/eprint/5791

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