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. |
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Asymptomatic athletes with no family history of inherited cardiac disease or SCD who has normal ECG Athletes with 2 or more borderline ECG findings or abnormal ECG findings requires further evaluation to |