Screening enables early detection of underlying cardiovascular disease, as well as enabling lifestyle modification and therapeutic intervention. However, a recent study of 11, 000 adolescent football players identified an incidence of SCD of closer to 6.8 per 100,000 athletes. The rate of SCD has previously been thought to be in the region of 1 in 50, 000. Young athletes demonstrate a 2.5-fold increased risk of SCD compared to sedentary individuals suggesting that sporting activity acts as a trigger for life-threatening arrhythmias in those with an underlying substrate. Sudden cardiac death (SCD) is the leading cause of death in athletes and a large proportion of these deaths are associated with undiagnosed cardiovascular disease. The sudden death of an athlete is a tragic event which is often highly publicised, particularly as athletes represent the healthiest individuals within society. This review aims to describe the evolution of the current knowledge on ECG interpretation as well as future directions.Īn athlete is defined as ‘one who participates in an organised team or individual sport requiring systematic training and regular competition against others, while placing a high premium on athletic excellence and achievement’. This evolution culminated in the recently published international recommendations for ECG interpretation in athletes (2017), which has led to a significant reduction in false positives and screening-associated costs. Interpretation of the athlete’s ECG has evolved over the past 12 years, beginning with the 2005 European Society of Cardiology (ESC) consensus, progressing to the ESC recommendations (2010), Seattle Criteria (2013) and the ‘refined’ criteria (2014). Erroneous interpretation may result in false reassurance or expensive investigations for further evaluation and unnecessary disqualification from competitive sports. Correct interpretation is therefore essential, in order to differentiate physiology from pathology. Such changes are common and may overlap with patterns suggestive of underlying cardiovascular disease. Screening for high-risk individuals enables early detection of pathology, as well as permitting lifestyle modification or therapeutic intervention.ĮCG changes in athletes occur as a result of electrical and structural adaptations secondary to repeated bouts of exercise. A large proportion of these deaths are associated with undiagnosed cardiovascular disease. Sudden cardiac death (SCD) is the leading cause of death in athletes.
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