Table 1: International Consensus Standards for Electrocardiographic Interpretation in Athletes. (adapted from Sharma, et al. [8]).

Normal ECG Borderline ECG Abnormal ECG

• Increased QRS voltage for LVH or RVH

• Incomplete RBBB

• Early repolarization/ST segment elevation

• ST elevation followed by T wave inversion V1-V4 in black athletes

• T wave inversion V1-V3 age < 16-year-old

• Sinus bradycardiao arrhythmia

• Ectopicatrial or junctional rhythm

• 1st degree AV block

• Mobitz Type I 2nd degree AV block

• Left axis deviation

• Left atrial enlargement

• Right axis deviation

• Right atrial enlargement

• Complete RBBB

• T wave inversion

• ST segment depression

• Pathological Q waves

• Complete LBBB

• QRS ≥ 140 ms duration

• Epsilon wave

• Ventricular pre-excitation

• Prolonged QT interval

• Brugada Type 1 pattern

• Profound sinüs bradycardia < 30 bpm

• PR interval ≥ 400 ms

• Mobitz Type II 2nd degree AV block

• 3rd degree AV Block

• ≥ 2 PVC

• Atrial tachyarrhythmias

• Ventricular tachyarrhythmias

AV = Atrioventriular block; LBBB = Left Bundle Branch Block; LVH = Left Ventricular Hypertrophy;
RBBB = Right Bundle Branch Block; RVH = Right Ventricular Hypertrophy; PVC = Premature
Ventricular Contraction; SCD = Sudden Cardiac Death.

Asymptomatic athletes with no family history of inherited cardiac disease or SCD who has normal ECG
findings or borderline ECG findings in isolation requires no further evaluation.

Athletes with 2 or more borderline ECG findings or abnormal ECG findings requires further evaluation to
investigate for pathologic cardiovascular disorders associated with SCD in athletes.