title: International Recommendations for Electrocardiographic Interpretation in Athletes.
abstract: Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly over the last decade; pushed by a growing body of scientific data that both tests proposed criteria sets and establishes new evidence to guide refinements. On February 26-27, 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington, to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.
authors.affiliation: Cardiology Clinical and Academic Group, St George's University of London, United Kingdom. Electronic address: sasharma@sgul.ac.uk.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Drezner
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Aaron
authors.initials: A
authors.lastname: Baggish
authors.affiliation: Cardiology Clinical and Academic Group, St George's University of London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Papadakis
authors.affiliation: Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar.
authors.forename: Mathew G
authors.initials: MG
authors.lastname: Wilson
authors.affiliation: Division of Cardiology, University of Washington, Seattle, Washington.
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Prutkin
authors.affiliation: Department of Cardiology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Andre
authors.initials: A
authors.lastname: La Gerche
authors.affiliation: Department of Cardiovascular Diseases, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ackerman
authors.affiliation: Department of Neuroscience and Physiology, Sahlgrenska University Hospital/Ostra Sahlgrenska Academy, Goteborg, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Borjesson
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Jack C
authors.initials: JC
authors.lastname: Salerno
authors.affiliation: Department of Family Medicine, University of South Carolina, Greenville, South Carolina.
authors.forename: Irfan M
authors.initials: IM
authors.lastname: Asif
authors.affiliation: Division of Cardiology, University of Washington, Seattle, Washington.
authors.forename: David S
authors.initials: DS
authors.lastname: Owens
authors.affiliation: Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Eugene H
authors.initials: EH
authors.lastname: Chung
authors.affiliation: Center of Cardiovascular Care in Athletics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Emery
authors.affiliation: Department of Medicine, Stanford University, Stanford, California.
authors.forename: Victor F
authors.initials: VF
authors.lastname: Froelicher
authors.affiliation: Department of Cardiology, Arrhythmology Hasselt University, Belgium; Department of Cardiology, Antwerp, Belgium.
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
authors.affiliation: Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar.
authors.forename: Carmen
authors.initials: C
authors.lastname: Adamuz
authors.affiliation: Georgia Southern University, Statesboro, Georgia.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Asplund
authors.affiliation: Division of Pediatric Cardiothoracic Surgery, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Gordon
authors.initials: G
authors.lastname: Cohen
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington.
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Harmon
authors.affiliation: Advocate Heart Institute, Normal, Illinois.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Marek
authors.affiliation: Division of Pediatric Cardiology, Baylor College of Medicine, Houston, Texas.
authors.forename: Silvana
authors.initials: S
authors.lastname: Molossi
authors.affiliation: University Institute of Sports Medicine, Paracelsus Medical University, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Niebauer
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington.
authors.forename: Hank F
authors.initials: HF
authors.lastname: Pelto
authors.affiliation: Center for Inherited Cardiovascular Disease, Stanford University, Stanford, California.
authors.forename: Marco V
authors.initials: MV
authors.lastname: Perez
authors.affiliation: Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Qatar.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Riding
authors.affiliation: Pediatric Cardiology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Tess
authors.initials: T
authors.lastname: Saarel
authors.affiliation: University of Herzzentrum, Zurich, Switzerland.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Schmied
authors.affiliation: Heart Center of Philadelphia, Jefferson University Hospitals, Philadelphia, Pennsylvania.
authors.forename: David M
authors.initials: DM
authors.lastname: Shipon
authors.affiliation: Department of Cardiology, Hospital de Clinicas de Porte Allegre, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Stein
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Vetter
authors.affiliation: Institute of Sports Medicine and Science, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pelliccia
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Corrado
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis*; D002648:Child; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography / Q000592:standards*; D006801:Humans; D013178:Sports Medicine; D055815:Young Adult
keywords: athlete; electrocardiogram