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Exercise ECG Beneficial in Pre-Sports Assessment

Cardiac abnormalities discovered on exercise ECG in patients with normal resting ECG

FRIDAY, Oct. 17 (HealthDay News) -- Adding exercise electrocardiography (ECG) to standard pre-participation sports evaluation may be beneficial because of pathological findings noted in participants with negative or innocent findings on physical examination and resting ECG, according to a report published in the Oct. 18 issue of BMJ.

Francesco Sofi, M.D., of the University of Florence in Italy, and colleagues performed a cross-sectional study of 30,065 pre-participation sports participants evaluating the utility of ECG screening in a cohort seeking to obtain clearance for competitive sports.

Abnormal resting 12-lead ECGs were seen in 1,812 participants (6 percent), with the most common abnormalities being benign: sinus bradycardia, complete or incomplete right bundle branch blocks, and early repolarization. Exercise ECGs were abnormal in 1,459 participants (4.9 percent) of which 1,227 athletes had normal findings on resting ECG, the report indicates. Overall, 196 participants (0.6 percent) were ineligible for competitive sports with 159 participants disqualified due to cardiac reasons. Of those disqualified for cardiac reasons, 126 (79.2 percent) demonstrated innocent or negative findings on resting 12-lead ECG but clear abnormalities during the exercise test, the researchers found.

"A consistent proportion of people disqualified for cardiac disorders showed innocent or negative findings on resting 12-lead ECG but clear pathological alterations on exercise ECG," Sofi and colleagues conclude. However, the authors point out, "because of the observational design of this study, we were unable to show if these clinical evaluations are effective in reducing the risk of mortality or incidence of cardiac accidents in sports participants."

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