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Review
. 2016 Apr-Jun;12(2):81-5.
doi: 10.14797/mdcj-12-2-81.

Electrocardiographic Evaluation in Athletes and Use of the Seattle Criteria to Improve Specificity

Kevin A Lisman  1
Affiliations
Review

Electrocardiographic Evaluation in Athletes and Use of the Seattle Criteria to Improve Specificity

Kevin A Lisman. Methodist Debakey Cardiovasc J. 2016 Apr-Jun.

Abstract

The screening of athletes for cardiovascular disease prior to participation can be challenging. Sustained training often leads to anatomical changes in the heart that can translate into electrocardiographic (ECG) abnormalities. This can lead to a high false-positive rate that excludes healthy participants or results in costly workups. The Seattle Criteria applied to ECG interpretation has resulted in improved specificity without sacrificing sensitivity. At the Houston Methodist DeBakey Heart & Vascular Center in Houston, we have had much success using this tool to screen thousands of athletes ranging across all age groups and levels of expertise-from the middle school level to the professional athlete.

Keywords: Seattle Criteria; athletic heart; cardiac adaptation; sudden cardiac death.

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Figures

Figure 1.
Figure 1.
Electrocardiogram showing upward concavity in the ST segment followed by positive T waves.
Figure 2.
Figure 2.
Electrocardiogram showing ST elevation with upward concavity followed by negative T waves in V1 through V4.
Figure 3.
Figure 3.
Electrocardiogram of a young athlete with HCM; note the deep T-wave inversion anteriorly and in the inferior leads, which is abnormal.
Figure 4.
Figure 4.
Electrocardiogram of a young athlete with hypertrophic cardiomyopathy presenting with pathologic Q waves.
Figure 5.
Figure 5.
Electrocardiogram of an athlete with arrhythmogenic right ventricular dysplasia.
See this image and copyright information in PMC

References

    1. Maron BJ, Doerer JJ, Haas ST, Tiemey DM, Mueller FO. Sudden death in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009 Mar 3;119(8):1088–92. - PubMed
    1. Maron BJ. Sudden death in young athletes. N Engl J Med. 2003 Sep 11;349(11):1064–75. - PubMed
    1. Corrado D, Basso C, Pavei A, Michieli P, Schiavon M, Thiene G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA. 2006 Oct 4;296(13):1593–601. - PubMed
    1. Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. N Engl J Med. 1998 Aug 6;339(6):364–9. - PubMed
    1. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991 Jan 31;324(5):295–301. - PubMed