title: The prevalence of abnormal ECG in trained sportsmen.
abstract: BACKGROUND
  Competitive sports training causes structural and conductive system changes manifesting by various electrocardiographic alterations. We undertook this study to assess the prevalence of abnormal ECG in trained Indian athletes and correlate it with the nature of sports training, that is endurance or strength training.
  
  
  METHODS
  We evaluated a standard resting, lying 12 lead Electrocardiogram (ECG) in 66 actively training Indian athletes. Standard diagnostic criteria were used to define various morphological ECG abnormalities.
  
  
  RESULTS
  33/66 (50%) of the athletes were undertaking endurance training while the other 33 (50%) were involved in a strength-training regimen. Overall 54/66 (81%) sportsmen had significant ECG changes. 68% of these changes were considered as normal training related features, while the remaining 32% were considered abnormal. There were seven common training related ECG changes-Sinus Bradycardia (21%), Sinus Arrhythmia (16%), 1st degree Atrioventricular Heart Block (6%), Type 1 2nd-degree Atrioventicular Heart Block (3%), Incomplete Right bundle branch block (RBBB) (24%), Early Repolarization (42%), Left Ventricular Hypertrophy (LVH) (14%); while three abnormal ECG changes--T-wave inversion (13%), RBBB(4%), Right ventricular hypertrophy (RVH) with strain (29%) were noted. Early repolarization (commonest change), sinus bradycardia, and incomplete RBBB were the commoner features noticed, with a significantly higher presence in the endurance trained athletes.
  
  
  CONCLUSIONS
  A high proportion of athletes undergoing competitive level sports training are likely to have abnormal ECG recordings. Majority of these are benign, and related to the physiological adaptation to the extreme levels of exertion. These changes are commoner during endurance training (running) than strength training (weightlifting).
authors.affiliation: Sports Physiologist, Army Sports Institute, Pune 411036, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Malhotra
authors.affiliation: Classified Specialist (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi, 110011, India.
authors.forename: Navreet
authors.initials: N
authors.lastname: Singh
authors.affiliation: Commanding Officer, Army Sports Institute, Pune 411036, India.
authors.forename: R S
authors.initials: RS
authors.lastname: Bishnoi
authors.affiliation: Senior Adviser (Medicine) and Cardiology, Military Hospital (Cardiothoracic Center), Pune 411040, India.
authors.forename: D S
authors.initials: DS
authors.lastname: Chadha
authors.affiliation: Consultant (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India.
authors.forename: P
authors.initials: P
authors.lastname: Bhardwaj
authors.affiliation: Senior Adviser (Medicine) and Cardiologist, Army Hospital (Research & Referral), New Delhi 110011, India.
authors.forename: H
authors.initials: H
authors.lastname: Madan
authors.affiliation: Consultant (Medicine) and Cardiologist, & Commandant, Armed Forces Clinic, Dalhousie Road, New Delhi 110001, India.
authors.forename: R
authors.initials: R
authors.lastname: Dutta
authors.affiliation: Senior Adviser (Medicine) and Cardiology, Command Hospital (Southern Command), Pune 411040, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Ghosh
authors.affiliation: Classified Specialist (Medicine) and Cardiologist, Military Hospital Jalandhar, Punjab, India.
authors.forename: S
authors.initials: S
authors.lastname: Sengupta
authors.affiliation: Nursing Assistant (Cardiology), Command Hospital (Southern Command), Pune 411040, India.
authors.forename: P
authors.initials: P
authors.lastname: Perumal
keywords: Competitive sports training; Electrocardiography; Endurance training; Sports cardiology; Strength training