Articles

Prevalence of Different Electrocardiographic Patterns in Iranian Athletes

Abstract

To explore the abnormalities in Iranian athletes' electrocardiogram and find any relation with body fat. 239 international athletes were involved in this cross sectional study. Body-fat percentage and resting 12-lead ECGs were recorded from all participants. Of 239 participant athletes, 212 were male and 27 female. 60% of participants had sinus bradycardia. A total of 84% of the athletes demonstrated at least 1 abnormal ECG finding. Average values for the PR, QRS and QT intervals, P-wave duration and QRS axis were in normal range. Frequencies of various ECG abnormal findings in all athletes were as follows: right axis deviation 4.2%, left ventricular hypertrophy 6.2%, sinus arrhythmia 5.8%, right bundle branch block (RBBB) 24.2% (incomplete RBBB 16.8%, complete RBBB 7.4%), ST elevation 72.5%, prolonged QT interval 1.7%, T inversion 3.1% and Mobitz type I 1.2%. The athletes' ECG response to treadmill stress test was normal with no ischemia or arrhythmia. The means of BMI and body-fat percentage were 24.04 ± 3.5 kg/m² and 9.15 ± 2.12%, respectively. Pearson correlation coefficient between body-fat percentage and ST changes was 0.65 (P=0.008) in anterior leads and 0.198 (P=0.017) in lateral leads. Also, the correlation coefficient between the body fat percentage and right bundle branch block was 0.36 (P=0.013). The results of current study support the inclusion of ECG in athletes' cardiac screening before they engage in vigorous exercises in order to detect the potentially fatal arrhythmias.

Corrado D, Biffi A, Basso C, Pelliccia A, Thiene G. 12- lead ECG in the athlete: physiological versus pathological abnormalities. Br J Sports Med 2009;43(9):669-76.

Rawlins J, Bhan A, Sharma S. Left ventricular hypertrophy in athletes. Eur J Echocardiogr 2009;10(3):350-6.

Pluim BM, Zwinderman AH, van der Laarse A, van derWall EE. The athlete's heart. A meta-analysis of cardiac structure and function. Circulation 2000;101(3): 336-44.

Westrol MS, Kapitanyan R, Marques-Baptista A, Merlin MA. Causes of sudden cardiac arrest in young athletes. Postgrad Med 2010;122(4):144-57.

Heidbüchel H, Hoogsteen J, Fagard R, Vanhees L, Ector H, Willems R, Van Lierde J. High prevalence of right ventricular involvement in endurance athletes with,ventricular arrhythmias. Role of an electrophysiologic study in risk stratification. Eur Heart J 2003;24(16):1473-80.

Papadakis M, Basavarajaiah S, Rawlins J, Edwards C, Makan J, Firoozi S, Carby L, Sharma S. Prevalence and significance of T-wave inversions in predominantlyCaucasian adolescent athletes. Eur Heart J2009;30(14):1728-35.

Corrado D, McKenna WJ. Appropriate interpretation of the athlete's electrocardiogram saves lives as well as money. Eur Heart J 2007;28(16):1920-2.

Hsieh BP, Pham MX, Froelicher VF. Prognostic value of electrocardiographic criteria for left ventricular hypertrophy. Am Heart J 2005;150(1):161-7.

Fuller CM. Cost effectiveness analysis of screening of high school athletes for risk of sudden cardiac death. Med Sci Sports Exerc 2000;32(5):887-90.

Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation 2007;116(22):2610-4; discussion 2615.

Selden MA, Helzberg JH, Waeckerle JF, Browne JE, Brewer JH, Monaco ME, Tang F, O'Keefe JH. Cardiometabolic abnormalities in current National Football League players. Am J Cardiol 2009;103(7):969-71.

Wilkerson GB, Bullard JT, Bartal DW. Identification of cardiometabolic risk among collegiate football players. J Athl Train 2010;45(1):67-74.

Pihl E, Jürimäe T. Relationships between body weight change and cardiovascular disease risk factors in maleformer athletes. Int J Obes Relat Metab Disord 2001;25(7):1057-62.

Azevedo LF, Brum PC, Rosemblatt D, Perlingeiro Pde S,Barretto AC, Negrão CE, de Matos LD. Cardiac and metabolic characteristics in long distance runners of sport and exercise cardiology outpatient facility of a tertiary hospital. Arq Bras Cardiol 2007;88(1):17-25.

Lawan A, Ali MA, Dan Bauchi SS. Evaluation of 12-lead electrocardiogram in athletes and non-athletes in Zaria, Nigeria. Pak J Physiol 2008;4:27-9.

Wheeler MT, Heidenreich PA, Froelicher VF, Hlatky MA, Ashley EA. Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Ann Intern Med 2010;152(5):276-86.

Sofi F, Capalbo A, Pucci N, Giuliattini J, Condino F, Alessandri F, Abbate R, Gensini GF, Califano S. Cardiovascular evaluation, including resting and exercise electrocardiography, before participation in competitive sports: cross sectional study. BMJ 2008;337:a346.

Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation 2007;116(22):2616-26; discussion 2626.

Ostman-Smith I, Wisten A, Nylander E, Bratt EL, Granelli AW, Oulhaj A, Ljungström E. Electrocardiographic amplitudes: a new risk factor for sudden death in hypertrophic cardiomyopathy. Eur Heart J 2010;31(4):439-49.

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IssueVol 50, No 8 (2012) QRcode
SectionArticles
Keywords
ECG Athletes Bradycardia Sudden cardiac death

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How to Cite
1.
Farahani B, Poursaeid Esfahani M, Abbasi MA, Moradi F, Abbasi A. Prevalence of Different Electrocardiographic Patterns in Iranian Athletes. Acta Med Iran. 1;50(8):560-564.