Department of Cardiology, Hypertension and Internal Disease, Medical University, Warsaw, Poland.
Kardiol Pol. 2009 Oct;67(10):1095-102.
One of the most important aims of modern sports cardiology is prevention of sudden cardiac death among athletes. Adequate pre-participation screening is a crucial part of prevention, however, current ACC, AHA or ESC guidelines are not uniform in this context. There is recently ongoing discussion on implementation of 12-lead ECG to the screening protocol.
To assess the prevalence of alterations of resting 12-lead ECG in a population of top-level professional athletes - members of the Polish Olympic Team - using recently accepted criteria.
During the period of intensive training before the Summer Olympic Games in Beijing (2008), a 12-lead, resting ECG was performed in 73 members (20 women and 53 men) of the Polish Olympic Team. Commonly accepted criteria were used to assess the ECG, and alterations were divided into two groups according to recent publications: group I - 'benign', common - thought to be consistent with the athlete's heart syndrome (i.e.: sinus bradycardia, 1st degree atrioventricular block, early repolarisation, right bundle branch hemiblock, isolated signs of left ventricular hypertrophy); and group II - 'suspected', uncommon - which may occur due to organic heart disease (i.e. complete bundle branch block, ventricular arrhythmia, inverse T wave or pathological QRS axis deviation).
Completely normal ECG was present in 11% of those examined, common (group I) findings were observed in 65% and 'suspected' (group II) in 23%. The most commonly occurring 'benign' findings were bradycardia incomplete, right bundle branch block and isolated left ventricular hypertrophy, found in 75, 71 and 41%, respectively. From 'suspected' (group II) the most frequent was left posterior fascicular hemiblock, present in 10% of those examined; other findings were complete right bundle branch block, left atrial hypertrophy, inverse T waves and left anterior fascicular hemiblock in single cases.
现代运动心脏病学的最重要目标之一是预防运动员心源性猝死。充分的赛前筛查是预防的关键部分，然而，目前的 ACC、AHA 或 ESC 指南在这方面并不统一。目前正在讨论将 12 导联心电图纳入筛查方案。
使用最近接受的标准，评估顶级职业运动员——波兰奥运代表队成员——静息 12 导联心电图改变的发生率。
在 2008 年北京夏季奥运会前的强化训练期间，对波兰奥运代表队的 73 名成员（20 名女性和 53 名男性）进行了 12 导联静息心电图检查。常用标准评估心电图，并根据最近的出版物将改变分为两组：I 组 - “良性”，常见 - 被认为与运动员心脏综合征一致（即：窦性心动过缓、一度房室传导阻滞、早期复极、右束支传导阻滞、孤立性左心室肥厚迹象）；II 组 - “可疑”，不常见 - 可能由器质性心脏病引起（即完全性束支传导阻滞、室性心律失常、倒置 T 波或病理性 QRS 轴偏移）。
完全正常的心电图在检查者中占 11%，常见（I 组）发现占 65%，“可疑”（II 组）占 23%。最常见的“良性”发现是不完全性心动过缓、右束支传导阻滞和孤立性左心室肥厚，分别占 75%、71%和 41%。“可疑”（II 组）中最常见的是左后束支传导阻滞，占检查者的 10%；其他发现包括完全性右束支传导阻滞、左心房肥厚、倒置 T 波和左前束支传导阻滞，均为单个病例。
