RT Journal Article
SR Electronic
T1 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
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 739
OP 745
DO 10.1136/bjsports-2017-098528
VO 54
IS 12
A1 Aneil Malhotra
A1 Harshil Dhutia
A1 Tee-Joo Yeo
A1 Gherardo Finocchiaro
A1 Sabiha Gati
A1 Paulo Bulleros
A1 Zephyr Fanton
A1 Efstathios Papatheodorou
A1 Chris Miles
A1 Tracey Keteepe-Arachi
A1 Joyee Basu
A1 Gemma Parry-Williams
A1 Keerthi Prakash
A1 Belinda Gray
A1 Andrew D'Silva
A1 Bode Ensam
A1 Elijah Behr
A1 Maite Tome
A1 Michael Papadakis
A1 Sanjay Sharma
YR 2020
UL http://bjsm.bmj.com/content/54/12/739.abstract
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.