Electrocardiographic Findings in National Basketball Association Athletes

Waase, Marc; Mutharasan, R. Kannan; Whang, William; DiTullio, Marco R.; DiFiori, John P.; Callahan, Lisa; Mancell, Jimmie; Phelan, Dermot; Schwartz, Allan; Homma, Shunichi; Engel, David

doi:10.1001/jamacardio.2017.4572

Cited by 35 publications

(33 citation statements)

References 17 publications

(54 reference statements)

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“…In a recent study of 519 National Basketball Association athletes' ECGs, early repolarization referred as convex ST segment elevation and T wave inversion in V2-V4 leads was the most frequent finding in black / African players. In the same study it was mentioned that abnormal findings were more prevalent in older athletes suggesting a possible correlation between long term high intensity training and ECG abnormalities [6]. In our case, ECG showed sinus bradycardia and ST segment changes that were in consistence with the above data.…”

Section: Discussionsupporting

confidence: 87%

ST Elevation in a Professional Athlete: From the Coronary Care Unit to the Field

Boutsikou¹,

Sanidas²,

Giasemis³

et al. 2019

CCR

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Interpretation of ECG in athletes can be quite challenging as it requires adequate experience to distinguish physiologic changes related to adaptation to training from pathologic findings. ECG interpretation is an important diagnostic tool for high intensity trained athletes. Herein, we present the case of a young high-competitive athlete who presented with a variant ST elevation on 12lead ECG that was initially considered suspicious of myocardial infarction. Diagnostic workup including clinical examination, echocardiogram, 12-lead surface ECG and laboratory tests (troponin and CK-MB) did not confirm the presence of acute coronary syndrome. The patient was monitored for a few hours and was finally discharged with no restrictions regarding training. ECG in the present case resembles Wellen's syndrome pattern which represents a preinfarction stage of CAD with a significant proximal left anterior descending artery (LAD) stenosis that will be followed by ACS of anterior wall if left untreated. However, there were no other findings to support the clinical diagnosis of Wellen's syndrome in our case and the ECG changes were attributed to a physiological adaptation to training. During exercise several ECG adjustments develop as a result of the decreased sympathetic tone and the increased parasympathetic tone combined with the heterogeneity of ventricle repolarization. The preparticipation screening performed by experienced physicians in the field of sports cardiology is crucial in order to recognize physiologic cardiovascular adaptation to exercise and exclude cardiovascular abnormalities.

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Section: Discussionsupporting

confidence: 87%

ST Elevation in a Professional Athlete: From the Coronary Care Unit to the Field

Boutsikou¹,

Sanidas²,

Giasemis³

et al. 2019

CCR

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“…International consensus has established standards of ECG interpretation in athletes and provided guidance on further testing and clinical evaluation of athletes (Sharma et al, ). Recent application of these international ECG criteria to differing athlete populations has yielded findings of abnormal ECG as low as 3% (Dhutia et al, ) and up to 15.6% (Waase et al, ) of those tested, a discrepancy that highlights knowledge gaps in understanding of the continuum of sex‐, race‐, and age‐specific characteristics of electrophysiological (EP) substrate in athletes (Heidbuchel, ). The vectorcardiogram (VCG) provides additional information to routine 12‐lead ECG evaluation (Waks et al, ).…”

Section: Introductionmentioning

confidence: 99%

Vectorcardiogram in athletes: The Sun Valley Ski Study

Thomas

Alday

Junell

et al. 2018

Noninvasive Electrocardiol

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Background Global electrical heterogeneity (GEH) is associated with sudden cardiac death (SCD) in adults of 45 years and above. However, GEH has not been previously measured in young athletes. The goal of this study was to establish a reference for vectorcardiograpic (VCG) metrics in male and female athletes. Methods Skiers (n = 140; mean age 19.2 ± 3.5 years; 66% male, 94% white; 53% professional athletes) were enrolled in a prospective cohort. Resting 12‐lead ECGs were interpreted per the International ECG criteria. Associations of age, sex, and athletic performance with GEH were studied. Results In age and training level‐adjusted analyses, male sex was associated with a larger T vector [T peak magnitude +186 (95% CI 106–266) µV] and a wider spatial QRS‐T angle [+28.2 (17.3–39.2)°] as compared to women. Spatial QRS‐T angle in the ECG left ventricular hypertrophy (LVH) voltage group (n = 21; 15%) and normal ECG group did not differ (67.7 ± 25.0 vs. 66.8 ± 28.2; p = 0.914), suggesting that ECG LVH voltage in athletes reflects physiological remodeling. In contrast, skiers with right ventricular hypertrophy (RVH) voltage (n = 26, 18.6%) had wider QRS‐T angle (92.7 ± 29.6 vs. 66.8 ± 28.2°; p = 0.001), larger SAI QRST (194.9 ± 30.2 vs. 157.8 ± 42.6 mV × ms; p < 0.0001), but similar peak SVG vector magnitude (1976 ± 548 vs. 1939 ± 395 µV; p = 0.775) as compared to the normal ECG group. Better athletic performance was associated with the narrower QRS‐T angle. Each 10% worsening in an athlete's Federation Internationale de’ Ski downhill ranking percentile was associated with an increase in spatial QRS‐T angle by 2.1 (95% CI 0.3–3.9) degrees (p = 0.013). Conclusion Vectorcardiograpic adds nuances to ECG phenomena in athletes.

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“…Improved accuracy was seen with the International Criteria versus the Seattle Criteria in National Basketball Association players, though 15.8% of African-American and 11.5% of white athletes still had abnormal ECGs with no imaging evidence of cardiac disease 49. Another study of almost 5000 athletes showed only 3.0% had an abnormal ECG with the new criteria, which was a 50% reduction compared with the Seattle Criteria 50.…”

Section: Resultsmentioning

confidence: 93%

Electrocardiography in athletes: normal and abnormal findings

Prutkin

Wilson

2018

Heart

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Many sporting organisations recommend a pre-participation ECG to screen for disorders which predispose to sudden cardiac arrest (SCA). The ability of the ECG to perform accurately is dependent on the ECG criteria used and the experience of the operator. There have been several ECG criteria over the last decade, though these were recently superseded with the publication of the 'International Consensus Criteria for ECG Interpretation in Athletes'. These criteria use the latest evidence to improve specificity while maintaining sensitivity for ECG-detectable pathologies associated with SCA. Accordingly, this review describes the normal, borderline and abnormal ECG findings in an asymptomatic athlete aged 12-35 years.

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Electrocardiographic Findings in National Basketball Association Athletes

Cited by 35 publications

References 17 publications

ST Elevation in a Professional Athlete: From the Coronary Care Unit to the Field

ST Elevation in a Professional Athlete: From the Coronary Care Unit to the Field

Vectorcardiogram in athletes: The Sun Valley Ski Study

Electrocardiography in athletes: normal and abnormal findings

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