PECULIARITIES OF THE ATHLETE’S ELECTROCARDIOGRAM: TRAINING-RELATED AND BORDERLINE CHANGES. PART 1

Abstract

Aim. This study aims to provide a review of scientific data on common training-related and borderline electrocardiogram (ECG) findings in athletes of various ages and training experiences. Materials and methods. This article presents the first part of a study analyzing Russian and international scientific literature on this topic. It describes a number of common training-related ECG findings in athletes. These findings are illustrated with actual ECG tracings recorded during in-depth medical examinations of athletes at the Ryazan Regional Medical Exercise Dispensary. Results. ECG findings in athletes are widespread and usually reflect benign structural, functional, and electrophysiological cardiac remodeling as an adaptation to regular, intense, and prolonged physical exercise. In accordance with international ECG interpretation criteria, athletes’ ECG findings are commonly divided into training-related, borderline, and pathological findings. Training-related ECG findings are associated with regular, intense, and prolonged physical exercise and do not require further investigation in the absence of symptoms or a history of inherited cardiovascular disease or sudden cardiac death. This article describes the following training-related ECG findings: sinus bradycardia, sinus arrhythmia, ectopic atrial rhythm and junctional escape rhythm, first-degree atrioventricular block, Mobitz type I second-degree atrioventricular block, incomplete right bundle branch block, and voltage criteria for ventricular hypertrophy. Conclusion. Knowledge of the common training-related ECG changes described in this article, along with the ability to correlate them with the athlete’s history and findings from other tests, will help minimize both overdiagnosis and underdiagnosis of heart disease in athletes.