Abstract 9479: Comparison of European Society of Cardiology and Circulation Criteria for Interpretation of the electrocardiogram in Young Athletes

Abstract

Background: adding ECG to cardiovascular screening of young athletes remains controversial. One of the reasons refers to the false positive rate of ECG requiring subsequent examinations and raising costs. In an attempt to increase specificity, the European Society of Cardiology (ESC) in 2010 and a group of experts in 2011 (Circulation - CIRC) have proposed recommendations for interpretation of ECG in athletes. The purpose of this study is to compare the ESC and the CIRC criteria for interpreting ECG in young athletes.

Methods: ECG was analysed as part of a prospective study about the impact of cardiovascular screening with ECG in young (14-35 years) competitive athletes. ECG was interpreted applying strictly the ESC criteria and the CIRC criteria. The rate of pathologic ECG following both criteria were compared.

Results: ECG of 1070 athletes (75 % males, age 19.7 ± 6.3 years) was analysed. ECG was considered pathologic in 211 (19.7 %) athletes following the ESC criteria and in 42 (3.9 %) athletes following the CIRC criteria (p < 0.001). In table 1 are reported the ECG changes in whom there were differences in pathologic ECG applying ESC and CIRC criteria.

Conclusions: strictly applying ESC criteria for interpretation of ECG in young athletes, in respect to CIRC criteria, results in a considerably higher proportion of pathologic ECG thus requiring more subsequent examinations. It appears that ESC criteria should be improved toward the best balance between false positive and negative findings.