COMPARISON OF THE ‘SEATTLE’ AND ‘INTERNATIONAL’ CRITERIA ELECTROCARDIOGRAM INTERPRETATION IN DIVISION II COLLEGE ATHLETES

Abstract

PURPOSE: A 12-lead exercise stress test is a screening tool used to detect abnormalities that may predispose collegiate athletes to sudden cardiac death. Experts in the field have developed new standardized criteria to better interpret electrocardiogram (ECG) in athletes. The purpose of this study was to compare the Seattle criteria to the most recently created International criteria in regards to ECG abnormalities in Division II collegiate athletes METHODS: Fifty-two athletes (Males = 26; Females = 26) completed cardiovascular screening with a resting 12-lead ECG analysis which was read and interpreted according to each criteria by an expert in the field of exercise science. ECGs were classified as ‘normal’ and ‘abnormal’ according to the parameters of each criteria and the abnormal condition was noted. Chi-square analysis was used to assess differences between criteria RESULTS: The total number of ECGs identified as abnormal decreased from 6 (11.5%) using the Seattle Criteria to 1 (1.9%) using the International Criteria (p < 0.05). The most common ECG abnormality identified using the International Criteria was T wave inversion 6 (11.5%). The newer definition of pathological Q waves reduced the number of ECGs identified as abnormal from pathologic Q waves from 3 (Seattle) to 1 (International) (66% reduction; p < 0.05). CONCLUSIONS: : Following the International Criteria for ECG interpretation significantly reduces the total abnormal and false-positive ECG rates in DII collegiate athletes compared to the Seattle Criteria without compromising sensitivity