A Resting ECG Screening Protocol Improved with Artificial Intelligence for the Early Detection of Cardiovascular Risk in Athletes

<b>Background/Objectives</b>: This study aimed to evaluate an artificial intelligence (AI)-enhanced electrocardiogram (ECG) screening protocol for improved accuracy, efficiency, and risk stratification across six sports: handball, football, athletics, weightlifting, judo, and karate. <b>Methods:</b> For each of the six sports, resting 12-lead ECGs from healthy children and junior athletes were analyzed using AI algorithms trained on annotated datasets. Parameters included the QTc intervals, PR intervals, and QRS duration. Statistical methods were used to examine each sport's specific cardiovascular adaptations and classify cardiovascular risk predictions as low, moderate, or high risk. <b>Results:</b> The accuracy, sensitivity, specificity, and precision of the AI system were 97.87%, 75%, 98.3%, and 98%, respectively. Among the athletes, 94.54% were classified as low risk and 5.46% as moderate risk with AI because of borderline abnormalities like QTc prolongation or mild T-wave inversions. Sport-specific trends included increased QRS duration in weightlifters and low QTc intervals in endurance athletes. <b>Conclusions:</b> The statistical analyses and the AI-ECG screening protocol showed high precision and scalability for the proposed athlete cardiovascular health risk status stratification. Additional early detection research should be conducted further for diverse cohorts of individuals engaged in sports and explore other diagnostic methods that can help increase the effectiveness of screening.