Electrocardiograms of Collegiate Football Athletes

Abstract

The prevalence of electrocardiogram (ECG) abnormalities in American collegiate football athletes is virtually unknown. The purpose of this study was to characterize the type and frequency of ECG abnormalities in a sample of football athletes entering National Collegiate Athletic Association (NCAA) Division I Football Bowl Subdivision university program. Over a 4-y period, resting and exercise 12-lead ECG recordings were analyzed by a cardiologist from 68 freshmen and 9 transfer football athletes (n=77; 54 African-Americans and 23 Caucasians, aged 18 +/- 1 y, height=1.89 +/- 0.06 m, weight= 104.4 +/- 19.8 kg) as part of their entry physical examination. A total of 79% of the athletes demonstrated at least 1 abnormal ECG finnding, and significantly more African-America athletes (85%) than Caucasian (65%) athletes. Wolff-Parkinson-White (WPW) syndrome was found in 1 African-American player. Frequencies of various ECG abnormal findings in all athletes were: left ventricular hypertrophy = 64.5%, ST-T wave = 6.5%, interventricular conduction delay = 2.6%, sinus bradycardia = 9.1%, sinus arrhythmia = 15.6%, first-degree atrioventricular (AV) block = 11.7%, left atrial enlargement = 48.1%, early repolarization = 33.8%, and right axis deviation = 20.8%. Average values for the PR (0.17 +/- 0.03 s), QRS (0.08 +/- 0.02 s), and QT intervals (0.38 +/- 0.05 s), P-wave duration (0.10 +/- 0.02 s), and QRS axis (79.1 +/- 18.2 degrees) were normal. The ECG responses to maximal treadmill exercise stress tests were evaluated as normal without ischemia or arrhythmias. Abnormal resting ECG findings are common in a sample of collegiate football athletes, exceeding the rate expected for their age, and are more frequent in African-American athletes as compared with Caucasian athletes.