ECG criteria

Through continuous improvement of diagnostic accuracy of ECG criteria for athletes sensitivity as well as specificity have grown so much that foregoing this screening tool is not feasible anymore. The most updated guidelines, the so-called “International (Seattle) Criteria” globally exhibit the most important reference publication, currently. The criteria were created with the purpose that particularly “non-cardiologists” should be able to use them before clearly pathological findings lead to further follow-up examinations at a specialist. On the other hand, physiologic ECG findings should not prompt expensive further evaluations, as it used to happen quite frequently.
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There was a longstanding controversy on the role of resting ECG in the preparticipation examination in athletes, as well as in children and adolescent, in leisure time or top athletes. Besides other arguments, this was due to the limited validity, to the false positive and false negative findings often followed by a thorough clinical examination. However, recent studies from different research groups yielded a significant improvement in establishing ECG criteria in athletes discriminating normal from abnormal or pathological findings in athletes.This in addition is supported and improved by a software-based ECG device considering the new Seattle criteria. These new criteria from the Seattle conference reliably discriminate normal from abnormal findings. Frequent ECG findings in athletes, especially in those engaged in endurance sports showed sinus bradycardia, AV-block and signs of left ventricular hypertrophy.
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