Rev. DERC (Online) 2020; 26(2): 91-99

Athlete’s ECG Intepretation: a Systematic Review

DOI: 10.29327/22487.26.2-8

Abstract

Cardiac adaptations to intense exercise may generate electrocardiographic changes that can be confused with signs of heart disease. The accurate interpretation of the findings depends on criteria that classify them as normal (related to exercise), borderline or abnormal (not related to exercise). A systematic review was carried out by searching the PubMed database in April 2020, using the terms: MeSH, electrocardiogram and athlete, with 159 review articles, systematic reviews and meta-analyzes in english, published in the last 5 years, being selected for eligibility analysis. A total of 29 articles were considered eligible, they addressed the interpretation criteria and/or alterations commonly found in the athlete’s electrocardiogram. The classic recommendations of the European Society of Cardiology (2010), the “Seattle Criteria” (2013) and the “Refined Criteria” (2014), significantly increased specificity without loss of sensitivity, and seeking to improve the interpretive criteria, in 2017 the “International Criteria” were published with some changes, but maintaining the normal, borderline and abnormal classification. In addition to the criteria, special attention should be paid to changes in the T wave in young people, suspicious after puberty, and in afro-descendants, unexpected when not confined to V1-V4, and to J point elevation, distinguishing the benign characteristics of early repolarization and malignant ones, as in Brugada. The dissemination, standardization and use of the current interpretation criteria is essential for sport to become even safer.