Comparative analysis of international electrocardiographic criteria usage in young athletes

Introduction and objectives: Electrocardiogram (ECG) screening in young individuals remains a matter of controversy due to relatively high false positive rates. In addition, validation of international criteria in athletes under 12 years of age has not yet been established. The intention of this study is to describe the prevalence of ECG findings in a sample of juvenile athletes aged 11-16 years. Material and method: Retrospective cross-sectional descriptive study of 14608 athletes aged 11 to 16 years, establishing children aged 11 to 12 years and adolescents aged 13 to 16 years. To assess the athletes, questionnaires on relevant background information were used by means of an interviewer. In addition, anthropometric measurements and resting ECG were performed. To measure the primary findings of abnormal ECGs, the international recommendations for electrocardiographic interpretation in athletes were followed. Results: Among the evaluated population of adolescent athletes, the vast majority howed results without pathological alterations in the ECG, with adaptive findings related to sports participation being more frequent among young adolescents and males. Of the total sample, 1.34% were diagnosed with a previously unknown cardiac pathology on ECG alone. Conclusions: The information collected provides valuable data on the prevalence of normal, abnormal and borderline ECGs in a very large sample of young athletes. These findings serve as a reference in the detection of potentially serious cardiac abnormalities within this specific group, considering variations according to age and sex. Furthermore, our findings highlight the use of the refined Seattle criteria as a sensitive and specific technique for the detection of juvenile athletes, further improving the accuracy of ECG-based assessments.