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Normal electrocardiographic findings: recognising physiological adaptations in athletes
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  1. Jonathan A Drezner,
  2. Peter Fischbach1,2,
  3. Victor Froelicher3,
  4. Joseph Marek4,
  5. Antonio Pelliccia5,
  6. Jordan M Prutkin6,
  7. Christian M Schmied7,
  8. Sanjay Sharma8,
  9. Mathew G Wilson9,
  10. Michael John Ackerman10,
  11. Jeffrey Anderson11,
  12. Euan Ashley3,
  13. Chad A Asplund12,
  14. Aaron L Baggish13,
  15. Mats Börjesson14,
  16. Bryan C Cannon15,
  17. Domenico Corrado16,
  18. John P DiFiori17,
  19. Kimberly G Harmon1,
  20. Hein Heidbuchel18,
  21. David S Owens6,
  22. Stephen Paul19,
  23. Jack C Salerno20,
  24. Ricardo Stein21,
  25. Victoria L Vetter22
  1. 1Department of Family Medicine, University of Washington, Seattle, Washington, USA
  2. 2Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
  3. 3Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California, USA
  4. 4Midwest Heart Foundation, Oakbrook Terrace, Illinois, USA
  5. 5Department of Medicine, Institute of Sport Medicine and Science, Rome, Italy
  6. 6Division of Cardiology, University of Washington, Seattle, Washington, USA
  7. 7Division of Cardiology, University Hospital Zurich, Zurich, Switzerland
  8. 8Department of Cardivascular Sciences, St. George's University of London, London, UK
  9. 9Department of Sports Medicine, ASPETAR, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar
  10. 10Divisions of Cardiovascular Diseases and Pediatric Cardiology, Departments of Medicine, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
  11. 11Department of Athletics, University of Connecticut, Storrs, Connecticut, USA
  12. 12Department of Family Medicine, Eisenhower Army Medical Center, Fort Gordon, Georgia, USA
  13. 13Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  14. 14Department of Cardiology, Swedish School of Sports and Health Sciences, Karolinska University Hospital, Stockholm, Sweden
  15. 15Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
  16. 16Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua, Italy
  17. 17Division of Sports Medicine, University of California Los Angeles, Los Angeles, California, USA
  18. 18Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
  19. 19Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
  20. 20Division of Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
  21. 21Cardiology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil, Brazil
  22. 22Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  1. Correspondence to Jonathan A Drezner, Department of Family Medicine, University of Washington, 1959 NE Pacific Street, Box 356390, Seattle, Washington 98195, USA; jdrezner{at}uw.edu

Abstract

Electrocardiographic changes in athletes are common and usually reflect benign structural and electrical remodelling of the heart as a physiological adaptation to regular and sustained physical training (athlete's heart). The ability to identify an abnormality on the 12-lead ECG, suggestive of underlying cardiac disease associated with sudden cardiac death (SCD), is based on a sound working knowledge of the normal ECG characteristics within the athletic population. This document will assist physicians in identifying normal ECG patterns commonly found in athletes. The ECG findings presented as normal in athletes were established by an international consensus panel of experts in sports cardiology and sports medicine.

  • Athletics
  • Physiology
  • Adaptations of skeletal muscle to exercise and altered neuromuscular activity

https://doi.org/10.1136/bjsports-2012-092068

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.

    • ▸ References to this paper are available online at http://bjsm.bmjgroup.com