Sports Medicine
The electrocardiogram in athletes: know your heart rhythm
What is an electrocardiogram?
The most striking thing is that it is a non-invasive test, requiring only that a few electrodes be placed on the person's skin. These electrodes are usually positioned on the chest and on the upper and lower limbs. As well as being painless, it transmits no electrical current: it simply captures cardiac activity in its natural state.
Simple though it is, the ECG is of great value for understanding heart health, both in people with cardiac symptoms and in athletes.
Why perform an ECG on an athlete?
Sudden death is a concern for athletes. In sport, the heart conditions known as arrhythmogenic right ventricular dysplasia (ARVD) and hypertrophic cardiomyopathy are a cause of death.
In ARVD, the normal cardiac muscle tissue in the right chamber of the heart is gradually replaced by fibrous and fatty tissue. This increases the risk of fatal arrhythmias.
In hypertrophic cardiomyopathy, the muscle of the left chamber of the heart thickens abnormally, which makes pumping blood more difficult.
Both conditions can be detected or suspected through a resting ECG. The ECG does not only help find cardiac problems: it is one of the most important tests for athletes when it comes to preventing and caring for heart health.
Beyond assessing a health problem, having an ECG brings peace of mind to the athlete and to their team in the practice of sport.
Are there differences between an ECG in an athlete and in the general population?
Yes — there are notable differences, because of the changes exercise produces in athletes' hearts. Some findings that might be seen as abnormal in the general population can be normal and common in athletes. This means the protocol for analysis and interpretation must be adjusted to obtain a result that is precise and relevant in a sporting context.
First, it is essential that the athlete is completely at rest and well rested before the test. This state guarantees a more precise analysis of cardiac activity under resting conditions.
Second, it is preferable that the health professional responsible for reading and analysing it is a physician specialized in sports medicine or cardiology. They should also understand the patient's profile, including their level of physical activity and the reason for the test. This allows them to apply the special criteria for athletes, which differ from those used for sedentary people.
How should ECG results be acted on?
If the results are normal or common, no further tests are needed. In this case it is advisable to repeat the ECG within a maximum of two years to maintain routine follow-up of heart health.
When the results are borderline, it is essential to follow the instructions of the physician specialized in sports medicine, who will design an individual follow-up plan to ensure any finding is managed appropriately.
When the results are abnormal or uncommon, further tests may be needed, such as an echocardiogram, along with review by a physician specialized in cardiology. These steps are essential to understand the situation better, and will allow specific measures to be put in place according to each patient's needs.
At Biuman we have a dedicated protocol for performing the electrocardiogram for athletes, both amateur and elite.
Our team of experts will perform the electrocardiogram with care and precision to assess your heart health and obtain the results needed. We will be here to answer your questions and guide you if you need further tests or consultations with other physicians.
Our priority is to give you peace of mind and confidence in the results, and to ensure precise follow-up of your heart health. Do get in touch to book your electrocardiogram and take the first step towards a healthier heart, and towards protecting your life while you exercise.
Your life and your safety are our priority!
Sources:
Carek, S. M., Edenfield, K. M., & Carek, P. J. (2020). Preparticipation Evaluation. Primary Care: Clinics in Office Practice, 47(1), 1-17. https://doi.org/10.1016/j.pop.2019.10.001
Drezner JA, Sharma S, Baggish A, et al. (2017). International criteria for electrocardiographic interpretation in athletes: Consensus statement. British Journal of Sports Medicine, 51(9), 704. https://doi.org/10.1136/bjsports-2016-097331