Abstract

IntroductionVery limited data exist on normal age-related ECG variations in adolescents and no data have been published regarding the ECG anomalies induced by intensive training, which are relevant in pre-participation screening for sudden cardiac death prevention in the adolescent athletic population. The purpose of this study was to establish normal age-related electrocardiographic measurements (P wave duration, PR interval, QRS duration, QT, and QTc interval) grouped according to 2-year age intervals.MethodsA total of 2,151 consecutive healthy adolescent Soccer athletes (trained for a mean of 7.2 ± 1.1 h per week, 100% male Caucasians, mean age 12.4 ± 1.4 years, range 7–18) underwent pre-participation screening, which included ECG and transthoracic echocardiography in a single referral center.ResultsTheir heart rate progressively slowed as age increased (p < 0.001, ranging from 80.8 ± 13.2 to 59.5 ± 10.2 bpm), as expected. The P wave, PR interval, and QRS duration significantly increased in older age classes (p = 0.019, p = 0.001, and p < 0.001, respectively), and after Bonferroni's correction, the difference remained significant in all age classes for QRS duration. The QTc interval diminished progressively with increasing age (p = 0.003) while the QT interval increased progressively (p < 0.001).ConclusionsSignificant variations in the normal ECG characteristics of young athletes exist between different age groups related to increasing age and training burden, thus, age-specific reference values could be adopted, as already done for echocardiographic measurements, and may help to further discriminate potentially pathologic conditions.

Highlights

  • Very limited data exist on normal age-related ECG variations in adolescents and no data have been published regarding the ECG anomalies induced by intensive training, which are relevant in pre-participation screening for sudden cardiac death prevention in the adolescent athletic population

  • Limited data [7] exist on normal age-related ECG changes in adolescents between different age groups and no data have been published regarding the athletic population classed into age intervals of 2 years

  • We have already published echocardiographic reference values related to physiological remodeling of the adolescent athlete’s heart in soccer players [8], in this study, we aimed to establish normal, age-related electrocardiographic measurements (P wave duration, PR interval, QRS duration, and QT and QTc interval) in a large cohort of adolescent athletes according to age at 2-year intervals, and to provide nomograms to better define the pediatric athlete’s heart

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Summary

Introduction

Very limited data exist on normal age-related ECG variations in adolescents and no data have been published regarding the ECG anomalies induced by intensive training, which are relevant in pre-participation screening for sudden cardiac death prevention in the adolescent athletic population. The purpose of this study was to establish normal age-related electrocardiographic measurements (P wave duration, PR interval, QRS duration, QT, and QTc interval) grouped according to 2-year age intervals. Limited data [7] exist on normal age-related ECG changes in adolescents between different age groups and no data have been published regarding the athletic population classed into age intervals of 2 years. We have already published echocardiographic reference values related to physiological remodeling of the adolescent athlete’s heart in soccer players [8], in this study, we aimed to establish normal, age-related electrocardiographic measurements (P wave duration, PR interval, QRS duration, and QT and QTc interval) in a large cohort of adolescent athletes according to age at 2-year intervals, and to provide nomograms to better define the pediatric athlete’s heart

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