European Heart Journal Advance Access originally published online on January 17, 2008
European Heart Journal 2008 29(5):680-681; doi:10.1093/eurheartj/ehm629
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Prevalence of positive ECG criteria in young competitive athletes: a single region experience
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del DeporteC. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Tel: +34 985 10 80 00
Fax: +34 985 10 80 00
Email: mmartinf7{at}hotmail.com
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del DeporteC. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del DeporteC. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del Deporte C. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del Deporte C. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del Deporte C. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del Deporte C. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
Area del Corazón del Hospital Central de
Asturias
Escuela de Medicina del Deporte C. Julián
Clavería s/n.
33006 Oviedo, Asturias
Spain
We have read with great interest the article by Pellicia et al. about prevalence of abnormal ECG in a large, unselected population undergoing pre-participation cardiovascular screening and also read the Editorial by Corrado and Mckenna. As it is known, implementation of 12-lead ECG in the pre-participation screening programme has been a complex area of debate during years.1 Arguments against implementation of ECG as a routine exam are purely economic, but there are others, like the possibility of false positive or the need of further analysis like echocardiogram, which could even increase the cost. However, as Pellicia et al.2 concludes, the prevalence of real ECG abnormalities is low (<5%) and this is what we really should know: to recognize the real positive ECG criteria. In the last European Congress of Cardiology, we communicated a similar work, in press at this moment, with 825 football players belonging to our Regional Sports Federation. Medical history, physical examination, and 12-lead ECG were practised on each one. Those with ECG defined as positive by the European Society of Cardiology (ESC criteria) underwent echocardiography assessment. ECG abnormalities were present in 61 (7%), of these 35 were repolarization abnormalities, four Wolff-Parkinson-White (WPW) syndrome, one borderline long QT syndrome, right bundle brunch block in eight, voltage criteria in four, right axis in five, ventricular ectopy in four, and in the echocardiogram we found one Hypertrophic cardiomyopathy (HCM), one was defined as an athlete's heart and five were included in the grey zone.3 So, in our study, we have found one HCM, who stopped sport activity and four WPW who underwent exercise testing and holter monitoring, otherwise they would have follow up competition and who knows? We really want to agree with Pellicia et al. and Corrado et al., as in our experience we also have a similar low prevalence of positive criteria, just a 7%, and call the authorities to think about the obligatory implementation of ECG in the pre-participation screening programme as a reflection of a society that promotes health.
References
- Corrado D, Mc Kenna WJ. Appropriate interpretation of the athlete's electrocardiogram saves lives as well as money. Eur Heart J (2007) 28:1920–1922.
[Free Full Text] - Pellicia A, Culasso F, Di Paolo F, Accettura D, Cantore R, Castsgna W, Ciacciarelli A, Costini G, Cuffari B, Drago E, Federici V, Gribaudo CG, Iacovelli G, Landolfi L, Menichetti G, Olla Atzeni U, Parisi A, Pizzi AR, Rosa M, Santelli F, Santilio F, Vagnini A, Casasco M, Di Luigi l. Prevalence of abnormal electrocardiogram in a large unselected population undergoing pre-participation cardiovascular screening. Eur Heart J (2007) 28:2006–2010.
[Abstract/Free Full Text] - Martín M, Rodríguez Reguero JJ, Calvo D, de la Torre A, Fernández A, García Castro M, Del Valle M, Morís de la Tassa C. Rendimiento del estudio electrocardiográfico en el reconocimiento deportivo de futbolistas federados de una comunidad autónoma. Rev Esp Cardiol. (in press).
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  M. Martin, J. J. R. Reguero, M. G. Castro, E. Coto, E. Hernandez, A. Carro, D. Calvo, and C. M. de la Tassa Hypertrophic cardiomyopathy and athlete's heart: a tale of two entities Eur J Echocardiogr, January 1, 2009; 10(1): 151 - 153. [Abstract] [Full Text] [PDF]
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