Table 3

Comparison of the prevalence of abnormal ECG findings representative of cardiomyopathy, pulmonary hypertension or primary electrical disturbance in 1078 elite athletes using the 2010 ESC criteria versus the Seattle Criteria

Group 2 ECG abnormality ESC criteria 2010n (%)Abnormal ECG
Seattle Criteria 2013

n (%)
Cardiomyopathy82 (7.6)Cardiomyopathy46 (4.3)
 LAD: −30° to −90°6 (0.6) “ ”6 (0.6)
 LAA: negative P wave V1/2 ≥1 mm deep and P duration >120 ms5 (0.5) “ ”5 (0.5)
 IVCD: any QRS duration >120 ms including RBBB and LBBB8 (0.7) Any QRS ≥140 ms or complete LBBB1 (0.1)
T wave inversion: deep: ≥2 mm, ≥2 adjacent leads
 OR ‘minor’ in ≥2 leads
69 (6.4) >1 mm deep, ≥2 leads in V2−6, II, aVF, I and aVL25 (2.3)
 ST segment depression: ≥0.5 mm deep in ≥2 leads2 (0.2) “ ”2 (0.2)
 Pathological Q waves: >4 mm deep in any lead except III, aVR2 (0.2) >3 mm deep and/or >40 ms duration in ≥2 leads except III and aVR2 (0.2)
Pulmonary hypertension33 (3.1)Pulmonary hypertension11 (1)
 RVH: RV1+SV5/V6>10.5 mm24 (2.2) ‘RVH pattern’: RV1+SV5>10.5 mm AND RAD >120°5 (0.5)
 RAD: >110°15 (1.4) –
 RAA: P wave >2.5 mm tall in II, III or aVF6 (0.6) “ ”6 (0.6)
Primary electrical disturbance81 (7.5)Primary electrical disturbance2 (0.2)
 Isolated PR <120 ms
 Ventricular pre-excitation
 7 (0.6)
1 (0.1)
 –
 “ ”
1 (0.1)
 LQTC: QTc >440 (M) or >460 (F)25 (2.3) QTc ≥ 470 (M) or ≥ 480 (F)0
 SQTC: QTc < 360 ms46 (4.3) QTc < 320 ms0
 Brugada type 1 ECG pattern0 “ ”0
Atrial tachyarrhythmias: SVT, atrial fibrillation/flutter0
Couplets, triplets, NSVT,0
≥2 PVCs per 10 s tracing1 (0.1)
 Abnormal ECG186 (17.3)48 (4.5)
  • Differences between criteria are outlined in text, “ ” denotes no difference and — denotes removal of criteria. The sum of all abnormalities exceeds the total number of athletes with an abnormal ECG due to the presence of multiple ECG abnormalities in some.

  • LAD, left axis deviation; LAA, left atrial abnormality; IVCD, intraventricular conduction delay; RVH, right ventricular hypertrophy; RAD, right axis deviation; RAA, right atrial abnormality; LQTC, long corrected QT interval; SQTC, short corrected QT interval; SVT, supraventricular tachycardia; NSVT, non-sustained ventricular tachycardia.