title: ECG findings in competitive rowers: normative data and the prevalence of abnormalities using contemporary screening recommendations.
abstract: OBJECTIVE
  The international governing body for competitive rowing recently mandated the inclusion of 12-lead ECG during preparticipation screening. We therefore sought to describe normative ECG characteristics and to examine the prevalence of abnormal ECG findings as defined by contemporary athlete ECG interpretation criteria among competitive rowers.
  
  
  METHODS
  Competitive rowers (n=330, 56% male) underwent standard 12-lead ECG at the time of collegiate preparticipation screening. ECGs were analysed quantitatively to develop a sport-specific normative database and then for the presence of abnormalities in accordance with the 2010 European Society of Cardiology (ESC) recommendations and 2013 'Seattle Criteria.'
  
  
  RESULTS
  94% of rowers had one or more training-related ECG patterns including sinus bradycardia (51%), sinus arrhythmia (55%), and incomplete right bundle branch block (42%). Males were more likely than females to have isolated voltage criteria for left ventricular hypertrophy (LVH) (51% vs 8%, p<0.001) and early repolarisation pattern (76% vs 23%, p<0.001). Application of the 2010 ESC criteria, compared to the Seattle criteria, resulted in the classification of a significantly greater number of abnormal ECGs (47% vs 4%; p<0.001). The detection of true pathology, accomplished by both interpretation criteria, was confined to a single case of ventricular pre-excitation.
  
  
  CONCLUSIONS
  Training-related ECG patterns with several gender-based differences are common among competitive rowers. The diagnostic accuracy and down-stream clinical implications of ECG-inclusive preparticipation screening among rowers will be dictated by the choice and future refinement of ECG interpretation criteria.
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Meagan M
authors.initials: MM
authors.lastname: Wasfy
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: James
authors.initials: J
authors.lastname: DeLuca
authors.affiliation: Harvard University Health Services, Cambridge, Massachusetts, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Wang
authors.affiliation: Harvard University Health Services, Cambridge, Massachusetts, USA.
authors.forename: Brant
authors.initials: B
authors.lastname: Berkstresser
authors.affiliation: Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts, USA Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Ackerman
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Eisman
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Lewis
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Adolph M
authors.initials: AM
authors.lastname: Hutter
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
authors.affiliation: Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA Harvard University Health Services, Cambridge, Massachusetts, USA.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Baggish
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009326:Naval Medicine; D012727:Sex Characteristics; D012767:Ships; D013177:Sports / Q000502:physiology*; D013178:Sports Medicine
keywords: Cardiology physiology; Rowing