title: International criteria for electrocardiographic interpretation in athletes: Consensus statement.
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, advanced by a growing body of scientific data and investigations that both examine proposed criteria sets and establish new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington (USA), 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: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Drezner
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, London, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, US.
authors.forename: Aaron
authors.initials: A
authors.lastname: Baggish
authors.affiliation: Cardiology Clinical Academic Group, St. George's, University of London, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Papadakis
authors.affiliation: Department of Sports Medicine, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Mathew G
authors.initials: MG
authors.lastname: Wilson
authors.affiliation: Division of Cardiology, University of Washington, Seattle, Washington, USA.
authors.forename: Jordan M
authors.initials: JM
authors.lastname: Prutkin
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Andre La
authors.initials: A
authors.lastname: Gerche
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.|Department of Paediatric, Mayo Clinic, Rochester, Minnesota, USA.|Department of Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.|Department of Molecular Pharmacology, Mayo Clinic, Rochester, Minnesota, USA.|Department of Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ackerman
authors.affiliation: Department of Neuroscience, Sahlgrenska University Hospital/Ostra Sahlgrenska Academy, Goteborg, Sweden.|Department of 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, US.
authors.forename: Jack C
authors.initials: JC
authors.lastname: Salerno
authors.affiliation: Department of Family Medicine, University of South Carolina, Greenville, USA.
authors.forename: Irfan M
authors.initials: IM
authors.lastname: Asif
authors.affiliation: Division of Cardiology, University of Washington, Seattle, Washington, USA.
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, USA.
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, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Emery
authors.affiliation: Department of Medicine, Stanford University, Stanford, California, USA.
authors.forename: Victor F
authors.initials: VF
authors.lastname: Froelicher
authors.affiliation: Hasselt University, Hasselt, Belgium.
authors.forename: Hein
authors.initials: H
authors.lastname: Heidbuchel
authors.affiliation: Department of Sports Medicine, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Carmen
authors.initials: C
authors.lastname: Adamuz
authors.affiliation: Georgia Southern University, Statesboro, Georgia, USA.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Asplund
authors.affiliation: Division of Paediatric Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.|Division of Cardiothoracic Surgery, University of California, San Francisco School of Medicine, San Francisco, California, USA.
authors.forename: Gordon
authors.initials: G
authors.lastname: Cohen
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Harmon
authors.affiliation: Advocate Heart Institute, Chicago, Illinois, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Marek
authors.affiliation: Division of Pediatric, Baylor College of Medicine, Houston, Texas, USA.|Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Silvana
authors.initials: S
authors.lastname: Molossi
authors.affiliation: University Institute of Sports Medicine, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Niebauer
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Hank F
authors.initials: HF
authors.lastname: Pelto
authors.affiliation: Center for Inherited Cardiovascular Disease, Stanford University, Stanford, California, USA.
authors.forename: Marco V
authors.initials: MV
authors.lastname: Perez
authors.affiliation: Department of Sports Medicine, ASPETAR, Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Riding
authors.affiliation: Department of Pediatrics, Cleveland Clinic, Cleveland, Ohio, USA.|Department of Cardiology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Tess
authors.initials: T
authors.lastname: Saarel
authors.affiliation: University Heart Center, Zurich, Switzerland.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Schmied
authors.affiliation: Heart Centre of Philadelphia, Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Shipon
authors.affiliation: Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Stein
authors.affiliation: The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
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 Science, University of Padua Medical School, Padua, Italy.|Department of Thoracic Sciences, University of Padua Medical School, Padua, Italy.|Department of Vascular Sciences, University of Padua Medical School, Padua, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Corrado
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D002648:Child; D032921:Consensus; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography / Q000592:standards*; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening; D013178:Sports Medicine / Q000592:standards*; D014861:Washington; D055815:Young Adult
keywords: Athlete; Cardiovascular; Sudden cardiac arrest; Sudden cardiac death