Table 1

Summary of the 2005 and 2010 European Society of Cardiology criteria for ECG interpretation in the athlete

Criteria for a positive 12-lead ECGCommon and training-related ECG changes (group 1)Uncommon and training-unrelated ECG changes (group 2)
P wave
  • Sinus bradycardia

  • First degree atrioventricular block

  • Incomplete RBBB

  • Early repolarisation

  • Isolated QRS voltage for LVH

  • T-wave inversion

  • ST-segment depression

  • Pathological Q waves

  • Left atrial enlargement

  • Left-axis deviation/left anterior hemiblock

  • Right-axis deviation/left posterior hemiblock

  • Right ventricular hypertrophy

  • Ventricular pre-excitation

  • Complete right or left bundle branch block

  • Long or short QT interval

  • Brugada-like early repolarisation

  • Left atrial enlargement

  • Right atrial enlargement

QRS complex
  • Frontal plane axis deviation

  • Increased voltage

  • Abnormal Q waves

  • Right or left bundle branch block

  • R or R' in lead V1 ≥0.5 mV in amplitude and R/S ratio ≥1

ST-segment, T waves and QT interval
  • ST-segment depression or T-wave flattening or inversion in ≥2 leads

  • Prolongation of heart rate corrected QT interval

Rhythm and conduction abnormalities
  • Premature ventricular beats or more severe ventricular arrhythmias

  • Supraventricular tachycardias, atrial fibrillation/flutter

  • Short PR interval with or without ‘delta’ wave

  • Sinus bradycardia with resting heart rate ≤40 beats/min

  • First, second, or third degree atrioventricular block

  • Summary of ECG criteria adopted from Corrado et al.9 13

  • LVH, left ventricular hypertrophy; RBBB, right bundle branch block.