Reliability and Validity of Clinician ECG Interpretation for Athletes

Magee, Charles; Kazman, Joshua; Haigney, Mark; Oriscello, Ralph G.; DeZee, M.P.H. Kent J.; Deuster, Patricia A.; Depenbrock, Patrick J.; O’Connor, Michael

doi:10.1111/anec.12138

Cited by 32 publications

(18 citation statements)

References 32 publications

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“…Lever et al [28] reported that only 11% of final--year medical students and resident medical officers accurately recognized the WPW-syndrome pattern. The results are consistent with a growing literature suggesting that non-cardiologists often have difficulties in interpreting ECG tracings [29]. The present study indicates that Emergency Department staff needs a special training in rare but potentially lethal arrhythmias as the misinterpretation of tachycardia etiology may result in adverse outcome [25][26][27].…”

Section: Discussionsupporting

confidence: 91%

Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome

et al. 2015

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Section: Discussionsupporting

confidence: 91%

Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome

et al. 2015

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“…Some studies have demonstrated that systematic evaluation of an athlete's ECG using standardised criteria improves interpretation accuracy 89 90. However, interobserver variability and the reliability of ECG standards even among experienced physicians remains a major concern 91 92. In one study, paediatric cardiologists, without the use of a standardised criteria set, achieved a sensitivity of 68% and a specificity of 70% for recognition of abnormal ECG patterns that occur infrequently, but may represent conditions predisposing to SCD 93…”

Section: Ecg For the Cardiovascular Screening Of Athletesmentioning

confidence: 99%

AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions

et al. 2016

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Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation cardiovascular screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcome-based evidence at this time precludes AMSSM from endorsing any single or universal cardiovascular screening strategy for all athletes, including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate cardiovascular screening strategy unique to their athlete population, community needs and resources. The decision to implement a cardiovascular screening programme, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. AMSSM is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes. BACKGROUND

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“…By using the Seattle criteria, the number of "abnormal" ECGs appears to be the smallest and there is less need for further diagnostic evaluation [6,24]. When the 2010 ESC guidelines were used, there were no differences in sensitivity and specificity in detection of abnormal ECG patterns between cardiologists and primary care specialists; however, cardiologists did, with significantly greater sensitivity, correctly diagnose the abnormal patterns [4,13].…”

Section: Pre-participation Cardiovascular Screening Protocolsmentioning

confidence: 99%

“…The incidence of SCDs in athletes under 35 years of age is between 0.4 in 100,000 in Italy, and 4.4 in 100,000 in the United States of America (USA), but it can be as high as 6 in 100,000 [2][3][4][5][6][7]. SCD death rate among athletes who are members of the National Collegiate Athletic Association (NCAA) was found to be 2.3 in 100,000 [8].…”

Section: Introductionmentioning

confidence: 99%

Sudden cardiac death and guidelines for pre-participation examination in athletes

2016

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Incidence of sudden cardiac death (SCD) in athletes under 35 years of age is between 0.4 and 4.4 in 100,000. The highest mortality is seen in older athletes (≥35 years) who engage in running, mostly because of complications of atherosclerotic coronary ischemic disease. Majority of European countries are guided by European Society of Cardiology’s (ESC) pre-participation screening (PPS) recommendations that include electrocardiography (ECG), while in the United States of America the ECG is not a routine part of the PPS examination. In Serbia, the ESC guidelines are being used, but there are no references prescribed by the Ministry of Health. The authors of this study believe that the national strategy for sport improvement should be accompanied with clear and well defined PPS recommendations that could be tenable in our health system.

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Reliability and Validity of Clinician ECG Interpretation for Athletes

Cited by 32 publications

References 32 publications

Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome

Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome

AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current evidence, knowledge gaps, recommendations and future directions

Sudden cardiac death and guidelines for pre-participation examination in athletes

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