title: Recommendations for interpretation of 12-lead electrocardiogram in the athlete.
abstract: Cardiovascular remodelling in the conditioned athlete is frequently associated with physiological ECG changes. Abnormalities, however, may be detected which represent expression of an underlying heart disease that puts the athlete at risk of arrhythmic cardiac arrest during sports. It is mandatory that ECG changes resulting from intensive physical training are distinguished from abnormalities which reflect a potential cardiac pathology. The present article represents the consensus statement of an international panel of cardiologists and sports medical physicians with expertise in the fields of electrocardiography, imaging, inherited cardiovascular disease, cardiovascular pathology, and management of young competitive athletes. The document provides cardiologists and sports medical physicians with a modern approach to correct interpretation of 12-lead ECG in the athlete and emerging understanding of incomplete penetrance of inherited cardiovascular disease. When the ECG of an athlete is examined, the main objective is to distinguish between physiological patterns that should cause no alarm and those that require action and/or additional testing to exclude (or confirm) the suspicion of an underlying cardiovascular condition carrying the risk of sudden death during sports. The aim of the present position paper is to provide a framework for this distinction. For every ECG abnormality, the document focuses on the ensuing clinical work-up required for differential diagnosis and clinical assessment. When appropriate the referral options for risk stratification and cardiovascular management of the athlete are briefly addressed.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Via Giustiniani 2, Padova, Italy. domenico.corrado@unipd.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Corrado
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Mark
authors.initials: M
authors.lastname: Link
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
authors.forename: Alessandro
authors.initials: A
authors.lastname: Biffi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Buja
authors.forename: Pietro
authors.initials: P
authors.lastname: Delise
authors.forename: Ihor
authors.initials: I
authors.lastname: Gussac
authors.forename: Aris
authors.initials: A
authors.lastname: Anastasakis
authors.forename: Mats
authors.initials: M
authors.lastname: Borjesson
authors.forename: Hans Halvor
authors.initials: HH
authors.lastname: Bjørnstad
authors.forename: François
authors.initials: F
authors.lastname: Carrè
authors.forename: Asterios
authors.initials: A
authors.lastname: Deligiannis
authors.forename: Dorian
authors.initials: D
authors.lastname: Dugmore
authors.forename: Robert
authors.initials: R
authors.lastname: Fagard
authors.forename: Jan
authors.initials: J
authors.lastname: Hoogsteen
authors.forename: Klaus P
authors.initials: KP
authors.lastname: Mellwig
authors.forename: Nicole
authors.initials: N
authors.lastname: Panhuyzen-Goedkoop
authors.forename: Erik
authors.initials: E
authors.lastname: Solberg
authors.forename: Luc
authors.initials: L
authors.lastname: Vanhees
authors.forename: Jonathan
authors.initials: J
authors.lastname: Drezner
authors.forename: N A Mark
authors.initials: NA
authors.lastname: Estes
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
authors.forename: Roberto
authors.initials: R
authors.lastname: Peidro
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Schwartz
authors.forename: Ricardo
authors.initials: R
authors.lastname: Stein
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Paolo
authors.initials: P
authors.lastname: Zeppilli
authors.forename: William J
authors.initials: WJ
authors.lastname: McKenna
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004562:Electrocardiography; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis; D007473:Ion Channels / Q000502:physiology; D018570:Risk Assessment; D012307:Risk Factors; D013177:Sports / Q000502:physiology*
chemical_list: D007473:Ion Channels