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Abnormal electrocardiographic findings in athletes: recognising changes suggestive of primary electrical disease
  1. Jonathan A Drezner1,
  2. Michael J Ackerman2,
  3. Bryan C Cannon3,
  4. Domenico Corrado4,
  5. Hein Heidbuchel5,
  6. Jordan M Prutkin6,
  7. Jack C Salerno7,
  8. Jeffrey Anderson8,
  9. Euan Ashley9,
  10. Chad A Asplund10,
  11. Aaron L Baggish11,
  12. Mats Börjesson12,
  13. John P DiFiori13,
  14. Peter Fischbach14,
  15. Victor Froelicher9,
  16. Kimberly G Harmon1,
  17. Joseph Marek15,
  18. David S Owens6,
  19. Stephen Paul16,
  20. Antonio Pelliccia17,
  21. Christian M Schmied18,
  22. Sanjay Sharma19,
  23. Ricardo Stein20,
  24. Victoria L Vetter21,
  25. Mathew G Wilson22
  1. 1Department of Family Medicine, University of Washington, Seattle, Washington, USA
  2. 2Departments of Medicine, Pediatrics, and Molecular Pharmacology and Experimental Therapeutics; Divisions of Cardiovascular Diseases and Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
  4. 4Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padova, Italy
  5. 5Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
  6. 6Division of Cardiology, University of Washington, Seattle, Washington, USA
  7. 7Division of Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
  8. 8Department of Athletics, University of Connecticut, Storrs, Connecticut, USA
  9. 9Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California, USA
  10. 10Department of Family Medicine, Eisenhower Army Medical Center, Fort Gordon, Georgia, USA
  11. 11Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  12. 12Swedish School of Sports and Health Sciences and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
  13. 13Division of Sports Medicine, University of California Los Angeles, Los Angeles, California, USA
  14. 14Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
  15. 15Midwest Heart Foundation, Oakbrook Terrace, Illinois, USA
  16. 16Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
  17. 17Department of Medicine, Institute of Sport Medicine and Science, Rome, Italy
  18. 18Division of Cardiology, University Hospital Zurich, Zurich, Switzerland
  19. 19Department of Cardiovascular Sciences, St George's University of London, London, UK
  20. 20Department of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
  21. 21Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
  22. 22Department of Sports Medicine, ASPETAR, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Jonathan A Drezner, Department of Family Medicine, University of Washington, 1959 NE Pacific Street, Box 356930, Seattle, Washington, 98195, USA; jdrezner{at}


Cardiac channelopathies are potentially lethal inherited arrhythmia syndromes and an important cause of sudden cardiac death (SCD) in young athletes. Other cardiac rhythm and conduction disturbances also may indicate the presence of an underlying cardiac disorder. The 12-lead ECG is utilised as both a screening and a diagnostic tool for detecting conditions associated with SCD. Fundamental to the appropriate evaluation of athletes undergoing ECG is an understanding of the ECG findings that may indicate the presence of a pathological cardiac disease. This article describes ECG findings present in primary electrical diseases afflicting young athletes and outlines appropriate steps for further evaluation of these ECG abnormalities. The ECG findings defined as abnormal in athletes were established by an international consensus panel of experts in sports cardiology and sports medicine.

  • Athletics
  • Injury Prevention

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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