PT  - JOURNAL ARTICLE
AU  - Aneil Malhotra
AU  - Harshil Dhutia
AU  - Tee-Joo Yeo
AU  - Gherardo Finocchiaro
AU  - Sabiha Gati
AU  - Paulo Bulleros
AU  - Zephyr Fanton
AU  - Efstathios Papatheodorou
AU  - Chris Miles
AU  - Tracey Keteepe-Arachi
AU  - Joyee Basu
AU  - Gemma Parry-Williams
AU  - Keerthi Prakash
AU  - Belinda Gray
AU  - Andrew D'Silva
AU  - Bode Ensam
AU  - Elijah Behr
AU  - Maite Tome
AU  - Michael Papadakis
AU  - Sanjay Sharma
TI  - Accuracy of the 2017 international recommendations for clinicians who interpret adolescent athletes’ ECGs: a cohort study of 11 168 British white and black soccer players
AID  - 10.1136/bjsports-2017-098528
DP  - 2020 Jun 01
TA  - British Journal of Sports Medicine
PG  - 739--745
VI  - 54
IP  - 12
4099  - http://bjsm.bmj.com/content/54/12/739.short
4100  - http://bjsm.bmj.com/content/54/12/739.full
SO  - Br J Sports Med2020 Jun 01; 54
AB  - Aim To investigate the accuracy of the recently published international recommendations for ECG interpretation in young athletes in a large cohort of white and black adolescent soccer players.Methods 11 168 soccer players (mean age 16.4±1.2 years) were evaluated with a health questionnaire, ECG and echocardiogram; 10 581 (95%) of the players were male and 10 163 (91%) were white. ECGs were retrospectively analysed according to (1) the 2010 European Society of Cardiology (ESC) recommendations, (2) Seattle criteria, (3) refined criteria and (4) the international recommendations for ECG interpretation in young athletes.Results The ESC recommendations resulted in a higher number of abnormal ECGs compared with the Seattle, refined and international criteria (13.2%, 4.3%, 2.9% and 1.8%, respectively). All four criteria were associated with a higher prevalence of abnormal ECGs in black athletes compared with white athletes (ESC: 16.2% vs 12.9%; Seattle: 5.9% vs 4.2%; refined: 3.8% vs 2.8%; international 3.6% vs 1.6%; p<0.001 each). Compared with ESC recommendations, the Seattle, refined and international criteria identified a lower number of abnormal ECGs—by 67%, 78% and 86%, respectively. All four criteria identified 36 (86%) of 42 athletes with serious cardiac pathology. Compared with ESC recommendations, the Seattle criteria improved specificity from 87% to 96% in white athletes and 84% to 94% in black athletes. The international recommendations demonstrated the highest specificity for white (99%) and black (97%) athletes and a sensitivity of 86%.Conclusions The 2017 international recommendations for ECG interpretation in young athletes can be applied to adolescent athletes to detect serious cardiac disease. These recommendations perform more effectively than previous ECG criteria in both white and black adolescent soccer players.