Pediatric Cardiologists' ECG Analyses Not Always Accurate

Sports participation accurately allowed in 74 percent, accurately forbidden in 81 percent of cases

THURSDAY, July 14 (HealthDay News) -- Electrocardiograms (ECG) administered to young athletes to determine the suitability of sports participation are difficult for pediatric cardiologists to interpret with complete accuracy, according to a study published online July 14 in The Journal of Pediatrics.

Allison C. Hill, M.D., from the Stanford University School of Medicine in California, and colleagues evaluated the accuracy of ECG interpretations by pediatric cardiologists. A total of 53 members of the Western Society of Pediatric Cardiology were given 18 ECGs to interpret, 10 from patients with conditions that commonly underlie sudden cardiac death and eight from patients with normal hearts. Two electrophysiologists provided gold-standard diagnoses and recommendations.

The investigators found that the average number of correct ECG interpretations per respondent was 12.4 (69 percent). Among the respondents, sensitivity and selectivity for recognition of any abnormality was 68 and 70 percent, respectively, with false-positive and false-negative rates of 30 and 32 percent, respectively. Based on actual ECG diagnoses, in 74 percent of cases, sports participation was accurately allowed, and in 81 percent of cases it was accurately forbidden. Correct information regarding sports participation was most common in long QT syndrome (98 percent) and myocarditis (90 percent), and least common in hypertrophic cardiomyopathy, Wolff-Parkinson-White syndrome, and pulmonary hypertension (80, 64, and 38 percent, respectively). The study respondents ordered more follow-up tests than the electrophysiologists.

"Preparticipation ECGs do not have perfect sensitivity or specificity, and the interpretations are difficult, even for pediatric cardiologists," the authors write.

One of the study authors disclosed a financial tie to Medtronic.

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