Article Text

Download PDFPDF
114 The prevalence of ECG abnormalities in young non-athletic individuals raises concerns regarding implementation of a nationwide screening program
  1. N Chandra1,
  2. J Rawlins2,
  3. M Papadakis3,
  4. C Edwards2,
  5. S Sharma2
  1. 1King's College Hospital, London, UK
  2. 2Kings College Hospital, London, UK
  3. 3Kings college Hospital, London, UK


Objectives Pre-participation screening of competitive athletes, combining 12-lead ECG with a health questionnaire and physical examination, has been demonstrated to reduce the incidence of sudden cardiac death (SCD) over a long term follow up period. Paradoxically, the vast majority of SCD occur in the non-athletic population and in the absence of antecedent symptoms. In the UK, screening for sinister cardiac disorders is confined only to those individuals with symptoms, or in the context of a family history of premature cardiac disease. In this study we analysed the prevalence of ECG abnormalities in young non-athletic individuals.

Methods Between April 2006 and November 2009, 2619 subjects (mean age 18.3 years; range 14–35; 80% male) were investigated with a health questionnaire and 12-lead ECG. The questionnaire related to symptoms suggestive of cardiovascular disease and a family history of premature cardiovascular disease and/or SCD. The 12-lead ECGs were analysed for specific abnormalities as described in the European Society of Cardiology sports cardiology consensus. Specific criteria for an abnormal ECG analysed include P wave abnormalities suggesting left or right atrial enlargement; QRS abnormalities suggesting left ventricular hypertrophy, interventricular conduction delay and frontal plane axis deviation; and ST segment depression and T wave flattening or inversion.

Results Of the 2619 individuals investigated a total of 505 (19.3%) individuals demonstrated one or more abnormalities on the 12-lead ECG. The abnormal findings are summarised in the table below:

Conclusions These results demonstrate that there is a high prevalence of ECG abnormalities when applying the ESC sports cardiology consensus criteria to young non-athletic individuals. Many of these abnormalities are non-specific in isolation and warrant further investigations to be carried out. This has significant implications on the feasibility and cost-effectiveness of a national cardiovascular screening programme for sinister cardiac disease.

  • sudden cardiac death
  • electrocardiogram
  • pre-participation screening

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.