Can standardized criteria enhance the accuracy of the interpretation of ECGs in pre-participation screening?

Abstract

Objective: Sudden cardiac death during sports is a relatively uncommon but impactful phenomenon. Athletes frequently do not show symptoms and SCD is the first sign. The two primary approaches are pre-participation examination and broadening the use of automated external defibrillators to decrease the occurrence of this deleterious event. A critical aspect of this exam involves assessing the resting 12-lead ECG. Evaluation of ECGs in deciding for eligibility of athletes is crucial. This study assesses the impact of "abnormal ECG criteria in athletes" on the ECG interpretation by sports medicine residents in Türkiye. Materials and Methods: A cross-sectional study was conducted by sending an online questionnaire to sports medicine residents in Türkiye. It was designed so that the same 40 ECGs were evaluated twice by the same residents. Abnormal ECG Criteria file has been delivered to participants after the initial evaluation and they were asked to assess the same 40 ECGs based on these criteria for the second evaluation. Results: Twenty-six participants completed both parts of the questionnaire. The median score of the before one-shot education session was 30.00, with minimum and maximum scores of 18 and 35, respectively. The median score of the after one-shot education session was 31.00, with minimum and maximum scores of 26 and 37, respectively. There was a significant increase in the total score after one-shot education session, based on the Wilcoxon signed rank test (p=0.035). Conclusion: Relying on the standardized criteria for ECG evaluation during pre-participation examination significantly improved the interpretations of sports medicine residents.