title: Prevalence of abnormal electrocardiograms in a large, unselected population undergoing pre-participation cardiovascular screening.
abstract: OBJECTIVE
  The implementation of 12-lead ECG in the pre-participation screening of young athletes is still controversial and number of issues are largely debated, including the prevalence and spectrum of ECG abnormalities found in individuals undergoing pre-participation screening.
  
  
  RESULTS
  We assessed a large, unselected population of 32,652 subjects [26 050 (80%) males], prospectively examined in 19 clinics associated to Italian Sports Medicine Federation. Most were young amateur athletes, aged 8-78 years (median 17), predominantly students (68%), engaged predominantly in soccer (39%), volleyball or basketball (8% each), athletics (6%), cycling (5%), swimming (4%). The ECG patterns were evaluated according to commonly used clinical criteria. The 12-lead ECG patterns were considered normal in 28 799 of the 32 652 athletes (88.2%) and abnormal in 3853 (11.8%). The most frequent abnormalities included prolonged PR interval, incomplete right bundle branch block (RBBB) and early repolarization pattern (total 2280, 7.0%). Distinct ECG abnormalities included deeply inverted T-waves in > 2 precordial and/or standard leads (751, 2.3%), increased R/S wave voltages suggestive of LV hypertrophy (247, 0.8%), conduction disorders, i.e. RBBB (351, 1.0%), left anterior fascicular block (162, 0.5%), and left bundle branch block (19, 0.1%). Rarely, cardiac pre-excitation pattern (42, 0.1%) and prolonged QTc interval (1, 0.03%) were found.
  
  
  CONCLUSIONS
  In a large, unselected population of young athletes undergoing pre-participation screening, the prevalence of markedly abnormal ECG patterns, suggestive for structural cardiac disease, is low (<5% of the overall population) and should not represent obstacle for implementation of 12-lead ECG in the pre-participation screening program.
authors.affiliation: Institute of Sports Medicine and Science (CONI), Via dei Campi Sportivi, 46, 00197 Rome, Italy. ant.pelliccia@libero.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
authors.forename: Franco
authors.initials: F
authors.lastname: Culasso
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Di Paolo
authors.forename: Domenico
authors.initials: D
authors.lastname: Accettura
authors.forename: Rocco
authors.initials: R
authors.lastname: Cantore
authors.forename: Walter
authors.initials: W
authors.lastname: Castagna
authors.forename: Alberto
authors.initials: A
authors.lastname: Ciacciarelli
authors.forename: Gioberto
authors.initials: G
authors.lastname: Costini
authors.forename: Biagio
authors.initials: B
authors.lastname: Cuffari
authors.forename: Enrico
authors.initials: E
authors.lastname: Drago
authors.forename: Vittorio
authors.initials: V
authors.lastname: Federici
authors.forename: Carlo Gabriele
authors.initials: CG
authors.lastname: Gribaudo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Iacovelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Landolfi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Menichetti
authors.forename: Umberto Olla
authors.initials: UO
authors.lastname: Atzeni
authors.forename: Attilio
authors.initials: A
authors.lastname: Parisi
authors.forename: Angelo R
authors.initials: AR
authors.lastname: Pizzi
authors.forename: Michele
authors.initials: M
authors.lastname: Rosa
authors.forename: Fabio
authors.initials: F
authors.lastname: Santelli
authors.forename: Franco
authors.initials: F
authors.lastname: Santilio
authors.forename: Alberto
authors.initials: A
authors.lastname: Vagnini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Casasco
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Luigi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D004562:Electrocardiography; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D013177:Sports