Abstract 15483: Prevalence and Determinants of Electrocardiographic Abnormalities in Children Undergoing Pre-Participation Screening
PURPOSE: The study addressed the prevalence, clinical significance and determinants of 12-lead electrocardiographic (ECG) abnormalities in a large and consecutive series of children undergoing pre-participation screening (PPS).
METHODS: The study population included 2770 subjects (1918 males, age 11.8±2.2 years). ECG abnormalities identified at PPS were classified into 2 subgroups according to the criteria proposed by the Section of Sport Cardiology of the European Society of Cardiology, i.e. common and training-related (Group 1) and uncommon and training-unrelated (Group 2). Subjects with Group 2 ECG abnormalities underwent further diagnostic work-up to confirm (or rule out) an underlying cardiovascular disease.
RESULTS: One or more ECG abnormalities were identified in 1314 subjects (47%): 1119 (40%) exhibited Group 1- and 195 (7%) Group 2-ECG abnormalities. Group 1 ECG abnormalities consisted of sinus bradycardia (6.2 %), first degree AV block (0.2 %), incomplete right bundle branch block (10.3 %), early repolarization pattern (11.9 %), isolated increase of QRS voltages (16.2%). Group 2 ECG abnormalities included ventricular depolarization changes (1.1%) and repolarization abnormalities (6%). T-wave inversion in >=2 contiguous leads was the most common ECG change (158 of 2770; 5.7%) and was most often observed in the leads exploring the right ventricle (V1-V2/V3). Among 195 subjects with Group 2 ECG abnormalities, further clinical evaluation led to identification of 14 subjects (7%) with cardiovascular disease at risk of sudden cardiac death: Wolf-Parkinson-White syndrome (n=6); arrhythmogenic right ventricular cardiomyopathy (n=3); long QT syndrome (n=2); short QT syndrome (n=1); Brugada syndrome (n=1); and hypertrophic cardiomiopathy (n=1).
CONCLUSIONS: ECG abnormalities are relatively common in children undergoing ECG-PPS. Most ECG changes reflected the physiological cardiac adaptation to physical exercise and/or the normal right precordial repolarization pattern in this age group. Further clinical investigation of those athletes with uncommon and training-unrelated ECG abnormalities led to identification of asymptomatic individuals with heart disease at risk of sudden cardiac death during sports.
- © 2011 by American Heart Association, Inc.