• athlete’s heart
• implementation
• position statement

In the last years, European and American organisations have presented rigorous position statements for guidance of physicians engaged in the cardiovascular screening of athletes as part of a preparticipation evaluation (PPE).1 2 In addition, continuous improvements of criteria for ECG interpretation in athletes over the last decade have yielded comprehensive updated international guidelines.3 Thus, the stage should be set for an evidence-based, best-practice cardiovascular PPE for the benefit of all competitive athletes included under each country’s or sports governing body’s regulations and recommendations. However, as pointed out in last year’s position statement from the American Medical Society for Sports Medicine,2 the long-standing debate regarding the inclusion or not of ECG in cardiovascular screening may have halted or clouded other important discussions and progress in the field. We believe one issue that has received far too little attention is the question of actual implementation of the cardiovascular PPE in sports clubs.

Notably, several reports from the USA have found …