Comentarios a los nuevos criterios internacionales para la interpretación del electrocardiograma del deportista / Comments on the new international criteria for electrocardiographic interpretation in athletes

La muerte súbita cardiaca es la principal causa de muerte durante la práctica deportiva. Diferentes trastornos cardiacos -estructurales o eléctricos- se asocian con la muerte súbita cardiaca de los deportistas y la mayoría muestra alteraciones en el electrocardiograma (ECG) de reposo. Sin embargo, la interpretación del ECG del deportista supone un reto, dado que las manifestaciones eléctricas de la adaptación fisiológica al entrenamiento pueden dificultar su diferenciación de algunas cardiopatías. Moduladores como la raza, la edad, el sexo, la modalidad deportiva, la historia deportiva y la intensidad del entrenamiento pueden dificultar aún más su interpretación, por lo que son necesarios conocimientos específicos y experiencia en la interpretación del ECG del deportista. Desde la publicación de las primeras recomendaciones de la Sociedad Europea de Cardiología en 2005, los criterios de interpretación del ECG del deportista han evolucionado rápidamente gracias a la creciente evidencia científica, que ha permitido mejorar su especificidad y, por lo tanto, reducir significativamente el número de falsos positivos sin afectar a la sensibilidad. Recientemente se ha publicado un nuevo documento de consenso internacional para la interpretación del ECG del deportista. El documento, fruto del consenso de expertos en cardiología y medicina del deporte reunidos en febrero de 2015 en Seattle (Estados Unidos), supone un importante hito, ya que, además de actualizar los criterios de interpretación del ECG, incluye recomendaciones sobre la actuación y la asistencia clínica al deportista con hallazgos anormales. En este artículo se exponen y se comentan los aspectos más relevantes y novedosos del documento; no obstante, es recomendable la lectura completa del original (AU)

Sudden cardiac death is the most common medical cause of death during the practice of sports. Several structural and electrical cardiac conditions are associated with sudden cardiac death in athletes, most of them showing abnormal findings on resting electrocardiogram (ECG). However, because of the similarity between some ECG findings associated with physiological adaptations to exercise training and those of certain cardiac conditions, ECG interpretation in athletes is often challenging. Other factors related to ECG findings are race, age, sex, sports discipline, training intensity, and athletic background. Specific training and experience in ECG interpretation in athletes are therefore necessary. Since 2005, when the first recommendations of the European Society of Cardiology were published, growing scientific evidence has increased the specificity of ECG standards, thus lowering the false-positive rate while maintaining sensitivity. New international consensus guidelines have recently been published on ECG interpretation in athletes, which are the result of consensus among a group of experts in cardiology and sports medicine who gathered for the first time in February 2015 in Seattle, in the United States. The document is an important milestone because, in addition to updating the standards for ECG interpretation, it includes recommendations on appropriate assessment of athletes with abnormal ECG findings. The present article reports and discusses the most novel and relevant aspects of the new standards. Nevertheless, a complete reading of the original consensus document is highly recommended (AU)

Comments on the New International Criteria for Electrocardiographic Interpretation in Athletes.

Sudden cardiac death is the most common medical cause of death during the practice of sports. Several structural and electrical cardiac conditions are associated with sudden cardiac death in athletes, most of them showing abnormal findings on resting electrocardiogram (ECG). However, because of the similarity between some ECG findings associated with physiological adaptations to exercise training and those of certain cardiac conditions, ECG interpretation in athletes is often challenging. Other factors related to ECG findings are race, age, sex, sports discipline, training intensity, and athletic background. Specific training and experience in ECG interpretation in athletes are therefore necessary. Since 2005, when the first recommendations of the European Society of Cardiology were published, growing scientific evidence has increased the specificity of ECG standards, thus lowering the false-positive rate while maintaining sensitivity. New international consensus guidelines have recently been published on ECG interpretation in athletes, which are the result of consensus among a group of experts in cardiology and sports medicine who gathered for the first time in February 2015 in Seattle, in the United States. The document is an important milestone because, in addition to updating the standards for ECG interpretation, it includes recommendations on appropriate assessment of athletes with abnormal ECG findings. The present article reports and discusses the most novel and relevant aspects of the new standards. Nevertheless, a complete reading of the original consensus document is highly recommended.