Comparison of the ‘Seattle’ and ‘International’ Criteria Electrocardiogram Interpretation in Division ii Female 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 bweetter interpret electrocardiogram (ECG) in athletes but most of the research has been focused on males. Therefore, it is important to continue to include females in future research to better define the unique ECG characteristics in this population. 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 female collegiate athletes METHODS: Thirty six females (age 20.2 ± 1.4 yrs; height 1.70 ± 0.7 m; weight 69.5 ± 8.9 kg) 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 any abnormal condition was noted. Chi-square analysis was used to assess differences between the two criteria. RESULTS: The total number of ECGs identified as abnormal decreased from 12 (33.3%) using the Seattle Criteria to 2 (5.6%) using the International Criteria (p < 0.05). The most common ECG abnormality identified using the International Criteria was T wave inversion 7 (19.4%). The newer definition of pathological Q waves reduced the number of ECGs identified as abnormal from 4 (Seattle) to 1 (International), a 75% reduction (p < 0.05). CONCLUSIONS: These results demonstrated that following the International Criteria for ECG interpretation significantly reduced the total abnormal and false-positive ECG rates in female collegiate athletes compared to the Seattle Criteria without compromising sensitivity. It is important to continue to conduct ECG research on female athletes in order to further define valid and reliable criteria for this under represented population.