Prevalence of physiological and pathological electrocardiographic findings in Hungarian athletes

Abstract

In Hungary, ECG is a keystone of routine athletic screening. Its significance is based on simplicity, quickness and high informative value as well as the fact that appearance of pathological ECG signs can precede the formation of structural heart diseases. During screening of healthy athletes, we studied the incidence of athletic ECG changes and pathological ECG abnormalities.

Methods: We performed detailed analysis of 12-lead ECG recordings of asymptomatic elite, non-elite and master athletes and controls.

Results: 227 athletes (male: 180, age: 27.2 ± 8.7 years) and 89 controls (male: 57, age: 28.1 ± 6.8 years) were examined. Benign ECG signs: sinus bradycardia, early repolarization and isolated Voltage criteria of left ventricular hypertrophy were common and more often in athletes compared to controls. Potentially pathological ECG signs: ST- (6.6% vs. 1.1%, p < 0.05) and T-wave (15.0% vs. 5.6%, p < 0.05) changes and signs of pathological left ventricular hypertrophy (5.3% vs. 0%, p < 0.05) occurred more frequently in athletes compared to controls.

Conclusions: Signs of pathological left ventricular hypertrophy and repolarization abnormalities are more often in athletes. No structural heart disease could be verified in the background of the disorders. However, athletes having pathological ECG should be kept under tight cardiology control. Exact definition and widespread knowledge of pathological ECG changes is essential in early recognition of high risk athletes.

Keywords: ECG; athlete; preparticipation screening; repolarization; sudden cardiac death.