Should axis deviation or atrial enlargement be categorised as abnormal in young athletes? the athlete's electrocardiogram: Time for re-appraisal of markers of pathology

European Heart Journal

Volumn 34, Issue 47, 2013, Pages 3641-3648

  Gati, Sabiha ^a,b   Sheikh, Nabeel ^a   Ghani, Saqib ^a   Zaidi, Abbas ^a   Wilson, Mathew ^c   Raju, Hariharan ^a   Cox, Andrew ^a   Reed, Matt ^a   Papadakis, Michael ^a   Sharma, Sanjay ^a,b  

^a ST GEORGE'S UNIVERSITY OF LONDON   (United Kingdom)

^b UNIVERSITY HOSPITAL LEWISHAM   (United Kingdom)

^c ASPETAR ORTHOPAEDIC AND SPORTS MEDICINE HOSPITAL   (Qatar)

Author keywords

Athlete's Heart; Electrocardiogram; Pre participation screening

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; ATHLETE; AXIS DEVIATION; BICUSPID AORTIC VALVE; CARDIOVASCULAR EQUIPMENT; CONGENITAL HEART DISEASE; CONTROLLED STUDY; ECG ABNORMALITY; ECHOCARDIOGRAPHY; ELECTROCARDIOGRAM; FALSE POSITIVE RESULT; FEMALE; HEART ATRIUM ENLARGEMENT; HEART DISEASE; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; MAJOR CLINICAL STUDY; MALE; MITRAL VALVE PROLAPSE; PATENT FORAMEN OVALE; PRACTICE GUIDELINE; PRIORITY JOURNAL; SENSITIVITY AND SPECIFICITY; ST SEGMENT DEPRESSION; T WAVE INVERSION; YOUNG ADULT;

ATHLETE'S HEART; ELECTROCARDIOGRAM; PRE-PARTICIPATION SCREENING;

ADOLESCENT; ADULT; CARDIOMEGALY; CARDIOMEGALY, EXERCISE-INDUCED; CARDIOMYOPATHY, HYPERTROPHIC; CASE-CONTROL STUDIES; COST-BENEFIT ANALYSIS; CROSS-SECTIONAL STUDIES; EARLY DIAGNOSIS; ELECTROCARDIOGRAPHY; FEMALE; HEART ATRIA; HUMANS; MALE; SPORTS; YOUNG ADULT;

EID: 84891366506     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/eht390     Document Type: Article

References (19)

1. Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. New Engl J Med 1998;339:364-369.
2. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006;296:1593-1601.
3. Maron BJ. Counterpoint: mandatory ECG screening of young competitive athletes. Heart Rhythm 2012;9:1646-1649.
4. Corrado D, Pelliccia A, Heidbuchel H, Sharma S, Link M, Basso C, Biffi A, Buja G, Delise P, Gussac I, Anastasakis A, Borjesson M, Bjornstad HH, Carre F, Deligiannis A, Dugmore D, Fagard R, Hoogsteen J, Mellwig KP, Panhuyzen-Goedkoop N, Solberg E, Vanhees L, Drezner J, Estes NA 3rd, Iliceto S, Maron BJ, Peidro R, Schwartz PJ, Stein R, Thiene G, Zeppilli P, McKenna WJ. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010;31:243-259.
5. Baggish AL, Hutter AM Jr,Wang F, Yared K,Weiner RB, Kupperman E, Picard MH, Wood MJ. Cardiovascular screening in college athletes with and without electrocardiography: a cross-sectional study. Ann Intern Med 2010;152:269-275.
6. Weiner RB, Hutter AM,Wang F, Kim JH,Wood MJ,Wang TJ, Picard MH, Baggish AL. Performance of the 2010 European Society of Cardiology criteria forECGinterpretation in athletes. Heart 2011;97:1573-1577.
7. Drezner JA, Fischbach P, Froelicher V, Marek J, Pelliccia A, Prutkin JM, Schmied CM, Sharma S,Wilson MG, Ackerman MJ, Anderson J, Ashley E, Asplund CA, Baggish AL, Borjesson M, Cannon BC, Corrado D, DiFiori JP, Harmon KG, Heidbuchel H, Owens DS, Paul S, Salerno JC, Stein R, Vetter VL. Normal electrocardiographic findings: recognising physiological adaptations in athletes. Br J Sports Med 2013;47: 125-136.
8. Drezner JA, Ashley E, Baggish AL, Borjesson M, Corrado D, Owens DS, Patel A, Pelliccia A, Vetter VL, Ackerman MJ, Anderson J, Asplund CA, Cannon BC, DiFiori J, Fischbach P, Froelicher V, Harmon KG, Heidbuchel H, Marek J, Paul S, Prutkin JM, Salerno JC, Schmied CM, Sharma S, Stein R, Wilson M. Abnormal electrocardiographic findings in athletes: recognising changes suggestive of cardiomyopathy. Br J Sports Med 2013;47:137-152.
9. Maron BJ, Maron MS. Hypertrophic cardiomyopathy. Lancet 2013;381:242-255.
10. Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, Basavarajaiah S, Carby L, Fonseca T, Sharma S. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur Heart J 2011;32:2304-2313.
11. Friedmann H. Diagnostic Electrocardiography and Vecterocardiography. New York: McGraw-Hill; 1971.
12. Bazett HC. The time relations of the blood-pressure changes after excision of the adrenal glands, with some observations on blood volume changes. J Physiol 1920; 53:320-339.
13. Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 1949;37:161-186.
14. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise J, Solomon S, Spencer KT, St John Sutton M, Stewart W. Recommendations for chamber quantification. Eur J Echocardiogr 2006;7:79-108.
15. Lakdawala NK, Thune JJ, Maron BJ, Cirino AL, Havndrup O, Bundgaard H, Christiansen M, Carlsen CM, Dorval JF, Kwong RY, Colan SD, Kober LV, Ho CY. Electrocardiographic features of sarcomere mutation carriers with and without clinically overt hypertrophic cardiomyopathy. Am J Cardiol 2011;108: 1606-1613.
16. Sharma S, Whyte G, Elliott P, Padula M, Kaushal R, Mahon N, McKenna WJ. Electrocardiographic changes in 1000 highly trained junior elite athletes. Br J Sports Med 1999;33:319-324.
17. Uberoi A, Stein R, Perez MV, Freeman J, Wheeler M, Dewey F, Peidro R, Hadley D, Drezner J, Sharma S, Pelliccia A, Corrado D, Niebauer J, Estes NA 3rd, Ashley E, Froelicher V. Interpretation of the electrocardiogram of young athletes. Circulation 2011;124:746-757.
18. Halkin A, Steinvil A, Rosso R, Adler A, Rozovski U, Viskin S. Preventing sudden death of athletes with electrocardiographic screening: What is the absolute benefit and how much will it cost?. J Am Coll Cardiol 2012;60:2271-2276.
19. Kreger BE, Cupples LA, Kannel WB. The electrocardiogram in prediction of sudden death: Framingham study experience. Am Heart J 1987;113:377-382.