Abnormal electrocardiogram findings in athletes

作者：Gherardo Finocchiaro, Alessandro Zorzi, Mark Abela, Aaron L. Baggish, Silvia Castelletti, Elena Cavarretta, Guido Claessen, Domenico Corrado, María Sanz‐de la Garza, Sabiha Gati, Viviana Maestrini, Aneil Malhotra, Josef Niebauer, David Niederseer, Michael Papadakis, Antonio Pelliccia, Sanjay Sharma, Flavio D’Ascenzi · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf646 · 被引用次数：9 · 研究领域：Cardiovascular Effects of Exercise、Cardiac Imaging and Diagnostics、Cardiac electrophysiology and arrhythmias

Athletes commonly exhibit a series of electrical, structural, and functional physiological changes which may overlap with cardiac pathology. The last two decades have witnessed a progressive improvement in understanding what can be considered benign for athletes and what may be deemed as potentially pathological and require further investigations. However, diagnostic uncertainties in the cardiac assessment of athletes are often encountered. In particular, the clinical significance of some electrocardiogram (ECG) findings may be uncertain. While uncommon and suggestive of an underlying cardiac condition, they may be identified among healthy athletes without additional pathological findings to support a unifying clinical diagnosis. This creates significant dilemmas for clinicians charged with determining sports eligibility and those who have the responsibility to help athletes in the decision-making process regarding future competitive sports participation. Current guidelines, recommendations, and position papers provide a roadmap for the differential diagnosis between 'athlete's heart' and cardiac disease. However, managing ECG findings of uncertain clinical significance, especially when initial diagnostic evaluation reveals no supportive signs of pathology, has received comparatively less attention, in particular, the type of cardiac investigations, the extent of diagnostic work-up and the need for follow-up require clarification. This document aims to provide guidance based ...