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Procedure: Electrocardiogram

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Pre-participation cardiovascular evaluation for athletic participants to prevent sudden cardiac death
The recent position article on pre-participation examination for athletic participants is appreciated.1 Most recommendations are in accordance with the EFSMA (European Federation of Sports Medicine Asssociations) statement.2 However, this position article1 requires some comments in order to avoid discouraging top and leisure time athletes from continuing intensive endurance training. The sensitivity and specificity of electrocardiogram (ECG) are based on the prevalence of a disease within the population. This holds true for resting and especially for stress testing ECG. The only reliable parameter, then, is predictive valu...
Source: Europace - February 28, 2017 Category: Cardiology Source Type: research

History of multiple sport-related concussions alters variability of heart rate response to activity
Conclusions A history of multiple sport-related concussions impairs the ability of the autonomic system to respond to an everyday stressor applied to the cardiovascular system (squatting and standing). This is an important finding, as it reveals that cumulative concussions may impart long-term impairments in the ability to accurately regulate the autonomic system. Competing interests None.
Source: British Journal of Sports Medicine - May 25, 2017 Category: Sports Medicine Authors: Wright, A. D., Grewal, H. S., Smirl, J. D., Bryk, K., Donkelaar, P. v. Tags: Abstracts Source Type: research

Heart rate variability reductions following a season of sub-concussive head hits are related to the magnitude of impacts experienced
Conclusions Exposure to repetitive subconcussive impacts overone season of contact-sport leads to decreases in heart rate variability. The magnitude of HRV reduction is related to the average magnitude of the linear component of hits to the head experienced during play Competing interests None.
Source: British Journal of Sports Medicine - May 25, 2017 Category: Sports Medicine Authors: Smirl, J. D., Wright, A. D., Grewal, H. S., Jakovac, M., Bryk, K., Donkelaar, P. v. Tags: Abstracts Source Type: research

Acute sport-related concussion suppresses heart rate variability beyond clinical recovery
Conclusions Acute sport-related concussions induce a delayed reduction in heart rate variability that does not manifest until near-clinical recovery, and persists until at least 1-month post-injury. This is an important finding, indicating that concussions impair regulation of the autonomic nervous system for a duration persisting well beyond clinical recovery. Competing interests None.
Source: British Journal of Sports Medicine - May 25, 2017 Category: Sports Medicine Authors: Wright, A. D., Smirl, J. D., Grewal, H. S., Bryk, K., van Donkelaar, P. Tags: Abstracts Source Type: research

Examining physiotherapist use of structured aerobic exercise testing to decrease barriers to aerobic exercise.
CONCLUSION: This study found that physiotherapists are regularly implementing aerobic exercise. This exercise was infrequently guided by formal aerobic exercise testing, which could increase access to safe and effective exercise within the optimal aerobic training zone. As well, this could facilitate training in patients with cardiovascular diagnoses that require additional testing for medical clearance. Increased ECG training and access to equipment for physiotherapists may augment pre-screening aerobic exercise testing. This training should include learning the key arrhythmias for aerobic exercise test termination as def...
Source: Physiotherapy Theory and Practice - April 3, 2018 Category: Physiotherapy Authors: Foster B Sc E, Fraser JE, Inness PhD EL, Munce S, Biasin L, Poon V, Bayley M Tags: Physiother Theory Pract Source Type: research

Cardiac Adaption to Exercise Training: the Female Athlete
AbstractPurpose of reviewThe number of female athletes participating in sports has increased exponentially over the past century. While cardiac adaptations to exercise have been well described, female athletes have been underrepresented in many prior studies. More recently, important research has embraced gender as an important biologic variable. We will review this work in order to examine how gender influences the impact of exercise on the heart.Recent findingsExercise-induced cardiac remodeling (EICR) manifests slightly differently in male and female athletes. Specifically, female athletes have fewer signs of EICR on th...
Source: Current Treatment Options in Cardiovascular Medicine - July 18, 2018 Category: Cardiology Source Type: research

The Accuracy of Acquiring Heart Rate Variability from Portable Devices: A Systematic Review and Meta-Analysis
ConclusionsOur results suggest that HRV measurements acquired using portable devices demonstrate a small amount of absolute error when compared to ECG. However, this small error is acceptable when considering the improved practicality and compliance of HRV measurements acquired through portable devices in the field setting. Practitioners and researchers should consider the cost –benefit along with the simplicity of the measurement when attempting to increase compliance in acquiring HRV measurements.
Source: Sports Medicine - January 31, 2019 Category: Sports Medicine Source Type: research

QT Corrections for Long QT Risk Assessment: Implications for the Preparticipation Examination
Conclusion: Our results support the application of the Fridericia-corrected threshold of 460 for men and 470 milliseconds for women (and 485 milliseconds for marked prolongation) rather than Bazett correction for the preparticipation examination.
Source: Clinical Journal of Sport Medicine - June 28, 2019 Category: Sports Medicine Tags: Original Research Source Type: research

Cardiopulmonary exercise testing in adult cardiology - expert opinion of the Working Group of Cardiac Rehabilitation and Exercise Physiology of the Polish Cardiac Society.
Abstract Cardiopulmonary exercise testing (CPET) is an important diagnostic tool in contemporary clinical practice. This document presents an experts opinion from the Working Group on Cardiac Rehabilitation and Exercise Physiology of the Polish Cardiac Society concerning the indications, performance technique, and interpretation of results for CPET in adult cardiology. CPET is an electrocardiographic exercise test expanded with exercise evaluation of ventilatory and gas exchange parameters. It allows for a global assessment of the exercise performance including the pulmonary, cardiovascular, hematopoietic, neurops...
Source: Polish Heart Journal - July 3, 2019 Category: Cardiology Authors: Smarż K, Jaxa-Chamiec T, Chwyczko T, Główczyńska R, Jegier A, Niedoszytko P, Piotrowicz E, Rybicki J, Straburzyńska-Migaj E, Szalewska D, Szmit S, Wolszakiewicz J Tags: Kardiol Pol Source Type: research

Evaluation of a Standardized Cardiac Athletic Screening for National Collegiate Athletic Association (NCAA) Athletes
Introduction: Sudden cardiac death is a rare cause of death in young athletes. Current screening techniques include history and physical exam (H and P), with or without an electrocardiogram (ECG). Adding point of care cardiac ultrasound has demonstrated benefits, but there is limited data about implementing this technology. We evaluated the feasibility of adding ultrasound to preparticipation screening for collegiate athletes.Methods: We prospectively enrolled 42 collegiate athletes randomly selected from several sports. All athletes were screened using a 14-point H and P based on 2014 American College of Cardiology (ACC) ...
Source: Western Journal of Emergency Medicine - August 15, 2019 Category: Emergency Medicine Source Type: research

Defining the Process of a Cardiovascular Risk Assessment Program: Lessons Learned From Cardiac Assessment of Elite Soccer Players in the United Kingdom
Conclusions: Cardiovascular assessment is a vital tool in identifying athletes at risk of sudden cardiac death to mitigate their risk through surveillance, intervention, or participation restriction. The decision whether a player is fit to play or not requires a robust risk assessment followed by input from a multidisciplinary team that includes both the team physician and cardiologist. This educational article proposes a clinical management pathway to aid clinicians with this process. Clinical Relevance: Sudden cardiac death is the important medical cause of death during exercise. The team physician should assume res...
Source: Clinical Journal of Sport Medicine - November 1, 2019 Category: Sports Medicine Tags: Original Research Source Type: research

Cardiovascular magnetic resonance clarifies arrhythmogenicity in asymptomatic young athletes with ventricular arrhythmias undergoing pre-participation evaluation.
In this study, asymptomatic young athletes with VRDs and normal PPE/echocardiography were optimally discriminated from healthy control athletes by CMR-derived indices, and CMR allowed for the identification of arrhythmogenic substrates in all cases. PMID: 32537014 [PubMed]
Source: Experimental and Therapeutic Medicine - June 18, 2020 Category: General Medicine Tags: Exp Ther Med Source Type: research

Etiology of Sudden Cardiac Arrest and Death in US Competitive Athletes: A 2-Year Prospective Surveillance Study
Conclusions: The etiology of SCA/D in competitive athletes involves a wide range of clinical disorders. More robust reporting mechanisms, standardized autopsy protocols, and accurate etiology data are needed to better inform prevention strategies.
Source: Clinical Journal of Sport Medicine - July 1, 2020 Category: Sports Medicine Tags: Original Research Source Type: research

Comparison of the Stanford ECG Left Atrial Criteria With the International ECG Criteria for Sports Screening
Conclusions: The Stanford evidence-based criterion for ECG-LAA incorporating V2 and replacing “or” for “and” regarding P wave duration increased the yield of abnormal classification for P waves. Future follow-up studies are needed to confirm that this new criterion should be included in future ECG screening consensus documents.
Source: Clinical Journal of Sport Medicine - July 1, 2021 Category: Sports Medicine Tags: Original Research Source Type: research

A comprehensive electrocardiographic analysis for young athletes
AbstractECG-based differences between athletes and sedentary adolescents are a frequently investigated subject in sports medicine. Especially, training-induced ECG variations are common in adult athletes and sustained training often leads to anatomical changes in the heart that can yield abnormalities in ECG. Therefore, ECG screening in athletes is important in diagnosis of cardiac problems of young athletes. The present work investigated the ECG characteristics of young athletes in terms of both gender and sedentary healthy young control group differences. Besides comparison between groups, analysis parameters were also i...
Source: Medical and Biological Engineering and Computing - August 3, 2021 Category: Biomedical Engineering Source Type: research