Thursday, 23 February 2017

This week new international standards have been published which will help doctors responsible for the cardiovascular care of athletes.

Sudden cardiac death is the leading cause of mortality in athletes during sport. The majority of disorders likely to cause cardiac problems can be suggested or identified by ECG (electrocardiogram) testing, but doctors in this field must be fully aware of the latest ECG interpretation guidelines.

In addition, athletes’ hearts can be outside normal parameters, and it is important that accurate knowledge is disseminated so that athletes aren’t unnecessarily advised to abandon a sporting career.

Cardiologists Professor Sanjay Sharma and Dr Michael Papadakis, of St George’s, University of London, led an international group developing new ECG criteria involving colleagues from Europe, the United States, and Australia.

The movement started in 2015 with an international summit in Seattle, Washington, hosted by the American Medical Society for Sports Medicine and the FIFA medical Assessment and Research Center. More than 30 of the world’s foremost authorities in sports cardiology and sports medicine took part in the summit, including Professor Sharma, who was at the time the Chair of the European Society of Cardiology’s Sports Cardiology Section.

Two years later, an international consensus has been reached, which updates ECG interpretation standards based on new research, largerly conducted by Professor Sharma’s group at St George’s. In addition, the recommendations provide a clear guide to evaluating ECG abnormalities for conditions associated with sudden cardiac death in athletes.

Dr Michael Papadakis said: “We hope that these criteria will further increase the specificity of the ECG as a screening tool for detecting potentially fatal conditions in our athletes, so that far fewer individuals will need to have unnecessary further testing.”

Professor Sanjay Sharma added: “These guidelines represent a real scientific collaboration and are a testament to the commitment of the sports medicine and sports cardiology communities to protect athletes during their career.”

The paper is online at the Journal of the American College of Cardiology and the European Heart Journal.