International consensus statement on an update of the classification criteria

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Evaluation Evaluation of profound sinus bradycardia should include assessing the chronotropic response to mild aerobic activity, such as running on the spot or climbing stairs. Profound first-degree heart block Mild to moderate first-degree heart block with a PR interval of to ms may be present in athletes due to increased vagal tone. Evaluation A small amount of aerobic activity should be performed to assess if the PR interval shortens appropriately. Considerations in high-dynamic athletes In high-level endurance athletes, such as cyclists, triathlon athletes and rowers, concern has been raised about the high volume and pressure loads on the right ventricle that could promote or induce ARVC.

Figure 20 ECG from a patient with arrhythmogenic right ventricular cardiomyopathy. Ventricular arrhythmias Ventricular couplets, triplets and non-sustained ventricular tachycardia always require investigation. Evaluation If ventricular arrhythmias are seen, the evaluation should include a thorough family history, an echocardiogram to evaluate for structural heart disease, cardiac MRI to assess for ARVC or other cardiomyopathies, ambulatory ECG monitor and exercise ECG test.

Temporary restriction during secondary evaluation of ECG abnormalities Temporary restriction from athletic activity should be considered for athletes with abnormal ECGs of uncertain clinical significance until secondary investigations are completed. Psychological considerations of caring for the athlete with potentially lethal cardiac disease Athletes diagnosed with serious cardiac diseases, regardless of the method used for disease detection, are at risk for psychological morbidity and represent an emotionally vulnerable population.

Conclusion Accurate ECG interpretation in athletes requires adequate training and an attention to detail to distinguish physiological ECG findings from abnormal ECG findings that might indicate the presence of cardiac pathology. Incidence of sudden cardiac death in national collegiate athletic association Athletes. Circulation ; : — Sudden deaths in young competitive Athletes: analysis of deaths in the United States, Incidence, etiology, and comparative frequency of sudden cardiac death in NCAA Athletes: a decade in review.

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Comparison of three current sets of electrocardiographic interpretation criteria for use in screening Athletes. Heart ; : — Standardised criteria improve accuracy of ECG interpretation in competitive Athletes: a randomised controlled trial. Br J Sports Med ; 48 : — Heart Rhythm ; 12 : — 6. Reliability and validity of clinician ECG interpretation for Athletes.

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Electrocardiographic changes in highly trained junior elite Athletes. Br J Sports Med ; 33 : — OpenUrl Abstract. The athletic heart syndrome. The standard electrocardiogram as a screening test for hypertrophic cardiomyopathy.

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Early repolarization patterns associated with increased arrhythmic risk are common in young non-Caucasian Australian males and not influenced by athletic status. Heart Rhythm ; 12 : — Benign clinical significance of J-wave pattern early repolarization in highly trained Athletes.

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ECG findings in competitive rowers: normative data and the prevalence of abnormalities using contemporary screening recommendations. Br J Sports Med ; 49 : — 6.

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Heart Rhythm ; 2 : — Accurate electrocardiographic assessment of the QT interval: teach the tangent. Heart Rhythm ; 5 : — 8. Bazett HC. An analysis of the time-relations of electrocardiograms. Heart : — Heart Rhythm ; 7 : — 9. Quantitative analysis of T wave abnormalities and their prognostic implications in the idiopathic long QT syndrome. Overview Fingerprint. Abstract New clinical, laboratory and experimental insights, since the publication of the Sapporo preliminary classification criteria for antiphospholipid syndrome APS , had been addressed at a workshop in Sydney, Australia, before the Eleventh International Congress on antiphospholipid antibodies.

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Journal of Thrombosis and Haemostasis. Miyakis, S. In: Journal of Thrombosis and Haemostasis. Reber and Y. Shoenfeld and A. AU - Lockshin, M. AU - Atsumi, T.