ECG in preparticipation screening of young athletes

Abstract

Introduction: The aim of the ECG in preparticipation screening of young athletes is detection of potential disorders in asymptomatic young athletes. Objective: The objective of the study was to determine the freqency and type of ECG changes observed during preparticipation screening of young athletes. Method: The research included analysis of ECG tests recorded during the regular preparticipation screening of 219 young athletes, aged from 9 to 19 years, predominantly male, who were engaged in 7 different sport disciplines. Standard ECG was recorded at least 24 hours after strenuous physical activity. ECG analysis was performed according to the European Society of Cardiology (ESC) recommendations for the interpretation of 12-lead ECG in the athletes, with corrections related to the inversion of T wave. Results: ECG was perfectly normal in 103 (47%), and ECG changes were noticed in 116 (53%) of the athletes. In 51.6% of examined athletes, ECG changes were of the common type, reflecting adaptation of the heart to regular exercises, and only in 1,4% athletes vwere founded ECG changes that are not consistent with training. The most common (32% of the total examinees) was incomplete right bundle branch block (RBBB). Sinus bradycardia was present in 12,8% of the athletes, and early repolarization at 7,8%. T wave inversion without clinical significance was observed in 4,1% of athlets. Isolated increase in QRS complex voltage was observed in 3,6%, while the first degree AV block was present in 0,5% of the athletes. ECG changes unrelated to training were recorded in 1,4% of athletes. Significant T wave inversion was observed in 0,9% and pre-excitation (Wolf-Parkinson-White syndrom) in 0,5% of the athletes. Conclusion: Preparticipation screening ECG test revealed ECG changes in 51,6% of young athletes. The vast majority of changes are of common, physiological type, that neither requires further investigation, nor termination of active participation in sports. In our study, in one athlete ECG changes required termination of sport activities, and two athletes continued active participation in sports, after additional testing.