International effort to define ECG interpretation standards in athletes

On Feb. 13-14, the American Medical Society for Sports Medicine (AMSSM) partnered with the European Society of Cardiology (ESC) Sports Cardiology Section, the Pediatric & Congenital Electrophysiology Society (PACES), other leading U.S. cardiologists, the British Journal of Sports Medicine (BJSM), and the FIFA Medical Assessment and Research Center (F-MARC) in an effort to define ECG interpretation standards in athletes and develop a comprehensive online training module for physicians around the world to gain expertise in ECG interpretation and the proper evaluation of ECG abnormalities suggestive of a pathologic cardiovascular disorder.

Hosted by AMSSM 1st Vice President Jonathan Drezner, MD, the meeting in Seattle, Wash., brought together many of the world's premier sports cardiologists and sports medicine physicians, including participants from the U.S., Italy, Sweden, U.K., Belgium, Switzerland, Brazil, and Qatar.

"This was an amazing meeting and truly an international effort," said Dr. Drezner. "The collaboration alone between U.S. and international cardiology and sports medicine leaders will move this field forward to improve the cardiovascular care of athletes."

Currently, there is a shortage of physician expertise world-wide in the interpretation of an athlete's ECG. Physician education in ECG interpretation using modern standards can help distinguish physiologic adaptations in athletes from ECG findings suggestive of underlying pathology.

The first day of the conference included outstanding presentations and spirited discussion to establish consensus ECG interpretation standards - the "Seattle Criteria." The criteria were developed with thoughtful attention to balance sensitivity (detection of diseases at-risk for sudden cardiac death) and specificity (false-positives).

Day two of the conference focused on the secondary evaluation of ECG abnormalities suggestive of disease. Topics such as hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, WPW, and long QT syndrome were reviewed to outline appropriate next steps in the evaluation of an abnormal ECG.

The group will translate their consensus recommendations into a comprehensive online training module hosted by British Medical Journal (BMJ) E-Learning. This state of the art E-learning resource will be freely accessible to any physician world-wide and help create a larger physician infrastructure that is skilled and capable of accurate ECG interpretation in athletes. Improved ECG interpretation may identify athletes with at-risk disorders and help prevent sudden death in sport.

Partners for the initiative include the AMSSM Foundation, FIFA, ESC Sports Cardiology Section, PACES, BJSM, the Nick of Time Foundation, Cardiac Science, Cardea Screen, and Parent Heart Watch.