ECG in Athletes

Abstract

Athletes require careful evaluation by specialized physicians to obtain eligibility for sport. In this context, electrocardiogram can be helpful to recognize patterns associated with heart disease that put the athletes at high risk of sudden cardiac death and may interdict participation in sports. On the other hand, adaptation to exercise may induce structural remodeling of the cardiac structures that results into electrocardiographic changes that are not associated with an increased risk of adverse events during exercise. Clearly, a correct interpretation of a resting 12-lead electrocardiogram is essential to differentiate athletes at risk of sudden cardiac death who must be prohibited from agonistic sports from those with physiologic changes who should be reassured and declared eligible for sport activities. Interpretation of the athlete’s ECG has evolved over the past 15 years, and in this chapter, we provide a brief review of current evidence regarding the electrocardiographic findings considered normal and abnormal in athletes based on the latest international recommendations.