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Das 12-Kanal-Ruhe-EKG in der sportmedizinischen Untersuchung von Kindern und Jugendlichen

Stellungnahme der Arbeitsgemeinschaft Herzkreislauferkrankungen der Gesellschaft für Pädiatrische Sportmedizin

The 12-lead resting ECG in sport medical examinations of children and adolescents

Statement of the working group on cardiovascular diseases of the Society of Pediatric Sports Medicine

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A Leserforum to this article was published on 25 June 2020

A Leserforum to this article was published on 25 June 2020

Zusammenfassung

Die Gesellschaft für pädiatrische Sportmedizin (GPS) will einen aktiven Lebensstil von Kindern und Jugendlichen fördern und unterstützt den grenzüberschreitenden Austausch von Experten mit dem Ziel, die körperliche Aktivität von Kindern, Jugendlichen und jungen Sportlern durch gemeinsame Positionen zu fördern.

Bis heute ist die Vorbeugung des plötzlichen Herztods („sudden cardiac death“, SCD) im Sport eine medizinische Herausforderung. Durch die Ableitung eines Ruhe-EKG können verschiedene SCD-bedingte elektrische oder strukturelle Herzerkrankungen vermutet oder diagnostiziert werden. Die Bedeutung des 12-Kanal-Ruhe-EKG zur Erkennung dieser Risikokonstellationen wird jedoch intensiv diskutiert.

Das GPS empfiehlt die Ableitung eines 12-Kanal-Ruhe-EKG als Standard für die sportmedizinische Untersuchung von wettkämpfenden Kindern und Jugendlichen ab einem Alter von 12 bis 14 Jahren, mindestens alle 2 Jahre. Eine sportartspezifische frühere Teilnahme an Wettbewerben ist individuell zu prüfen.

Aktuelle Empfehlungen zur Beurteilung des Ruhe-EKG bei Sportlern, die trainingsbedingte Herzanpassungen in Betracht ziehen, führen zu einer bestmöglichen Sensitivität und Spezifität. Um jedoch nachteilige Folgen von falsch-negativen oder falsch-positiven Befunden zu vermeiden, muss die Beurteilung von Ärzten und Kinderärzten durchgeführt werden, die über Fachkenntnisse in pädiatrischer Sportmedizin und der aktueller Kriterien verfügen.

Abstract

The Society for Pediatric Sports Medicine (GPS) aims to promote an active lifestyle for children and adolescents and supports transnational exchange of experts with the aim of promoting physical activity in children, adolescents and young athletes through common positions.

To date, the prevention of sudden cardiac death (SCD) in sports still poses a medical challenge. By establishment of a resting electrocardiogram (ECG), various SCD-related electrical or structural heart conditions can be suspected or diagnosed. Nevertheless, the importance of the 12-lead resting ECG used to detect these risk constellations is under intensive discussion.

The GPS recommends the derivation of a preparticipation 12-lead resting ECG as a standard in sports medical examinations of children and adolescents who compete in sports, at least every 2 years beginning from the age of 12–14 years. A sport-specific earlier participation in competitions must be individually controlled.

Current recommendations for the assessment of the resting ECG in athletes, which take the training-related cardiac adaptations into consideration, lead to the best possible sensitivity and specificity; however, to avoid disadvantageous consequences from false negative or false positive findings, the assessment must be done by physicians and pediatricians with expertise in pediatric sports medicine and the currently used criteria.

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Authors and Affiliations

  1. Sektion Pädiatrische Kardiologie, Universitätsklinik für Kinder- und Jugendmedizin Ulm, Ulm, Deutschland

    Jannos Siaplaouras & Christian Apitz

  2. Pädiatrische Kardiologie Graz, Graz, Österreich

    Peter Fritsch

  3. Interdisziplinäres Zentrum für Sport & Bewegungsmedizin, Universitätsklinik für Kardiologie, Inselspital, Universitätsspital Bern, Bern, Schweiz

    Matthias Wilhelm

  4. Institut für Epidemiologie, Biostatistik und Prävention, Gruppe Children, Physical Activity and Health (CHIPAH), Universität Zürich, Zürich, Schweiz

    Susi Kriemler

  5. Praxis am Herz-Jesu-Krankenhaus, 36039, Fulda, Deutschland

    Jannos Siaplaouras

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  1. Jannos Siaplaouras
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Correspondence to Jannos Siaplaouras.

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J. Siaplaouras, C. Apitz, P. Fritsch, M. Wilhelm und S. Kriemler geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Siaplaouras, J., Apitz, C., Fritsch, P. et al. Das 12-Kanal-Ruhe-EKG in der sportmedizinischen Untersuchung von Kindern und Jugendlichen. Monatsschr Kinderheilkd 167, 1157–1161 (2019). https://doi.org/10.1007/s00112-019-00796-9

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