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Who Should Interpret Screening Preparticipation ECGs in Young Athletes?

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Abstract

Purpose of review

As many physicians include screening ECGs for sports clearance of young athletes, the question arises: who should interpret these ECGs? We provide an overview of who currently interprets these ECGs and offer insight on how to improve this process.

Recent findings

Wide variation in training in interpretation of ECGs exists among the providers interpreting screening ECGs of young athletes. The International Criteria is effective at identifying risk and reducing false positives when interpreting ECGs in athletes 12–35 years old, but no standardized training/certification requirements exist. Data is lacking for the use of the International Criteria in athletes outside of these ages.

Summary

We propose that licensed physicians with competency utilizing the International Criteria should interpret ECGs in young athletes ages 12–35 years old. It is reasonable to require training/certification as evidence of competency. Patients < 12 or > 35 years old should be considered on a case-by-case basis. Future studies may expand the age parameters. The advancement and use of automated ECG interpretation software and artificial intelligence have the potential to make ECG screening more accurate, cost-effective, and available.

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Authors and Affiliations

  1. Pediatric and Adult Congenital Electrophysiology Fellow, Medical University of South Carolina, 10 McClennan Banks Drive MSC 915, Charleston, SC, 29425, USA

    Alexander Hutchinson MD

  2. University of Texas at Austin Dell School of Medicine, Austin, TX, USA

    Nicolas K. Goff BS

  3. Pediatric and Adult Congenital Electrophysiology, Medical University of South Carolina, Charleston, SC, USA

    Nicole Cain MD & Lanier Jackson MD

  4. Pediatric and Sports Cardiology, University of Virginia, Charlottesville, VA, USA

    Peter N. Dean MD

  5. Pediatrics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Deepak Kamat MD, PhD

Authors
  1. Alexander Hutchinson MD
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  2. Nicolas K. Goff BS
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  3. Nicole Cain MD
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  4. Peter N. Dean MD
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  5. Deepak Kamat MD, PhD
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  6. Lanier Jackson MD
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Contributions

A.H. wrote the main manuscript, and prepared Tables 3 and 4. N.G. assisted with main manuscript authorship, and prepared Tables 1 and 2. N.C. provided pediatric electrophysiology expertise with guidance and edits to the main manuscript, and identified and provided the majority of ECG's referenced in the tables. P.D. provided sports medicine expertise with guidance and edits to the main manuscript, and provided the main content for Table 4. D.K. provided general pediatric expertise with guidance and significant edits to the main manuscript. L.J. was the senior author of this work, with significant contributions to all aspects of the work including assisting in writing of the main manuscript, providing content for all four tables, and final edits for the entire work.

Corresponding author

Correspondence to Alexander Hutchinson MD.

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Conflict of Interest

Nicole Cain reports payment for travel to the Women in EP, Abbott educational conference. Peter N. Dean reports the following: in 2023 paid honoraria for talk on sports participation in patients with congenital heart disease at Sports Cardiology Summit for Elite and Professional Athletes in New York, NY; in 2022 paid honoraria for guest editor for Clinics in Sports Medicine issue. In addition, in 2022, Dr. Dean reports that he reviewed medical records for a defendant in a case of cardiac arrest and possible myocarditis in young child. Deepak Kamat reports payments made to them from the American Academy of Pediatrics for being the editor of AAP textbooks. In addition, Dr. Kamat reports support from the AAP National Conference and Exhibition for covering all costs for attending the meeting. Alexander Hutchinson declares no potential conflicts of interest. Nicolas K. Goff declares no potential conflicts of interest. Lanier Jackson declares no potential conflicts of interest.

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Hutchinson, A., Goff, N.K., Cain, N. et al. Who Should Interpret Screening Preparticipation ECGs in Young Athletes?. Curr Treat Options Cardio Med 25, 851–864 (2023). https://doi.org/10.1007/s11936-023-01029-9

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