Prevalence of electrocardiographic abnormalities in elite and sub-elite professional athletes

Objective: The objective of this study is to determine the prevalence of electrocardiographic abnormalities that could endanger the lives of elite and sub-elite professional athletes based on normal, borderline, and abnormal findings described in international recommendations. Material and method: This retrospective observational study was performed only on men elite football players, men elite baseball players, men elite basketball players, and men sub-elite football players (second division, third division, U-15, U-17, and U-20). Data were collected from pre-competition ECGs performed by team-affiliated physicians in the 2012 – 2019 preseasons of active-roster athletes and sub-elite players. The qualitative characteristics of each ECG were analyzed using the international recommendations for electrocardiographic interpretation in athletes to detect accepted training-related ECG findings and findings classified as borderline and abnormal. Results: A total of 716 ECGs were included. Common training-related ECG changes were found in 63.1%; sinus bradycardia was the most prevalent training-related ECG change (47.2%). The prevalence of borderline ECG readings among all the participants was 3.9%; the most frequent change was right axis deviation. The prevalence of abnormal ECG findings overall was 4.2%. Conclusion: Electrocardiographic changes in athletes are frequently seen; however, a constant review of changes within abnormal or borderline parameters is recommended. It is suggested that further research studies should study the electrocardiographic changes in elite and sub-elite athletes and compare these changes considering the biological sex of the athletes to see if there are any differences.