Variabilidade na interpretação do eletrocardiograma do atleta: mais uma limitação na avaliacão pré-competitiva

Translated title of the contribution: Variability in interpretation of the electrocardiogram in athletes: another limitation in pre‐competitive screening

Hélder Alexandre Correia Dores*, José Ferreira Santos, Paulo Dinis , Francisco Moscoso Costa, Lígia Lopes Mendes, José Monge, António Freitas, Pedro de Araújo Gonçalves, Nuno Cardim, Miguel Mendes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Assessment of the electrocardiogram (ECG) in athletes remains controversial, with lack of standardization and difficulty in applying specific criteria in its interpretation. The purpose of this study was to assess variability in the interpretation of the ECG in athletes.Twenty ECGs of competitive athletes were assessed by cardiologists and cardiology residents, 11 of them normal or with isolated physiological changes and nine pathological. Each ECG was classified as normal/physiological or pathological, with or without the use of specific interpretation criteria.The study presents responses from 58 physicians, 42 (72.4%) of them cardiologists. Sixteen (27.6%) physicians reported that they regularly assessed athletes and 32 (55.2%) did not use specific ECG interpretation criteria, of which the Seattle criteria were the most commonly used (n=13). Each physician interpreted 15±2 ECGs correctly, corresponding to 74% of the total number of ECGs (variation: 45%-100%). Interpretation of pathological ECGs was correct in 68% (variation: 22%-100%) and of normal/physiological in 79% (variation: 55%-100%). There was no significant difference in interpretation between cardiologists and residents (74±10% vs. 75±10%; p=0.724) or between those who regularly assessed athletes and those who did not (77±12% vs. 73±9%; p=0.286), but there was a trend for a higher rate of correct interpretation using specific criteria (77±10% vs. 72±10%; p=0.092). The reproducibility of the study was excellent (intraclass correlation coefficient=0.972; p<0.001). Conclusions: A quarter of the ECGs were not correctly assessed and variability in interpretation was high. The use of specific criteria can improve the accuracy of interpretation of athletes’ ECGs, which is an important part of pre-competitive screening, but one that is underused.
Translated title of the contributionVariability in interpretation of the electrocardiogram in athletes: another limitation in pre‐competitive screening
Original languagePortuguese
Pages (from-to)443-449
Number of pages7
JournalRevista Portuguesa de Cardiologia
Volume36
Issue number6
DOIs
Publication statusPublished - 7 Jun 2017
Externally publishedYes

Keywords

  • Electrocardiogram
  • Interpretation
  • Variability
  • Athletes

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