Twelve-lead electrocardiography in the young: Physiologic and pathologic abnormalities (original) (raw)
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Pre-Participation ECG Screening in Military Recruits
Arquivos Brasileiros de Cardiologia, 2013
Background: The findings and additional investigations required based on pre-participation electrocardiography (ECG) among military recruits are poorly defined in the literature. Objectives: This study was designed to evaluate the rate of abnormal findings on pre-participation ECG in young adults and the additional evaluations required based on these findings. Methods: A retrospective cohort study was performed in the Israeli Air Force (IAF) aero medical screening center for flight academy and elite units' candidates. Flight academy and elite units' candidates undergo pre-participation ECG prior to enlistment to the Israeli Defense Forces (IDF). Since 2010, all ECGS have been performed at the IAF aero medical center. All ECGs performed since January 2010 were analyzed by one of three cardiologists and all those in which significant findings were identified were referred to further evaluation upon the cardiologist's request. Causes of referral for further evaluation, the evaluations performed and the results of these evaluations are reported for the study population. Results: 1455 ECGS were performed in the years 2010-2011. Of these, 1388 (95.39%) were interpreted as normal. 67 subjects were referred to further evaluation based on ECG findings. The most common findings leading to further evaluation were T wave changes (16 cases, 23.88%), pre-excitation pattern (14, 20.89%) and voltage criteria for left ventricular hypertrophy (11, 16.41%). Only 7 subjects (10.44%) had abnormal findings which were considered clinically significant at the end of the medical evaluation. Conclusions: The rate of significant findings leading to disqualification from military activity is extremely low and referral to continued investigations based on 12-lead ECG findings should be judicious (Arq Bras Cardiol. 2013;100(3):269-273).
Electrocardiographic Abnormalities in Medically Screened Military Aircrew
Aviation, Space, and Environmental Medicine, 2012
Background: The European Society of Cardiology (ESC) recently published its updated recommendations for electrocardiogram (ECG) interpretation in athletes. It distinguishes ECG changes related to physical training (group 1 abnormalities) from training-unrelated changes (group 2) which may represent underlying electrical and structural heart disorders implicated in exercise related sudden cardiac death. This study sought to prospectively apply the ESC screening criteria to a large cohort of screened military aircrew. Methods: This was a prospective observational study. The 12-lead ECGs of 868 consecutively evaluated healthy aircrew were analyzed for the presence of ESC-defi ned group 1 and 2 abnormalities. Results: The average age was 39.6 (11.2) yr (95.4% male). Overall, 402 (46.3%) of ECGs could be classifi ed as entirely normal. However, 466 ECGs (53.7%) were abnormal. Group 1 abnormalities were identifi ed in 400 (46.1%) persons with 66 (7.6%) persons classifi ed as having group 2 abnormalities. The most commonly identifi ed group 1 ECG changes were sinus bradycardia (32.5%), early repolarization (11.8%), and isolated voltage criteria of left ventricular hypertrophy (10.1%). The most commonly noted group 2 abnormalities were left-axis deviation/left anterior hemiblock (2.4%), T-wave inversion (1.6%), and ST-segment depression (1.3%). Prolongation of the QTC. 0.46 s was observed in 0.69% of ECGs. Conclusions: The vast majority of ECGs performed in military aircrew could be classifi ed as representing likely normal physiological changes. Training unrelated ECG changes, suggestive of possible genuine cardiac pathology, were observed in only a minority of persons who should be considered for further investigation.
2020
ObjectiveTo determine the effect of electrocardiogram (ECG) screening on prevention of sudden cardiac arrest and death (SCA/D) in young athletes and military members.DesignSystematic review and meta-analysisData SourcesMEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, were searched from inception to date searched between 2/21/19 and 3/1/19, and Clinicaltrials.gov on 7/29/19. All databases were searched without limits on language.Eligibility criteria for selected studiesRandomized and non-randomized controlled trials, where pre-participation examination including ECG was the primary intervention used to screen athletes or military 40 years of age or younger. Accepted controls were no screening, usual care, or pre-participation examination without ECGResults4 studies (11,689,172 participants) were included, all at high risk of bias. Pooled data from two studies (n= 3,869,274; very low quality) showed a 42% relative decrease in sudden cardiac death...
Pacing and Clinical Electrophysiology, 2003
GIALAFOS, E.J., ET AL.: P Wave Analysis Indices in Young Healthy Men. Data from the Digital Electrocardiographic Study in Hellenic Air Force Servicemen (DEHAS). P wave analysis from the 12-lead ECG is a recent contribution of noninvasive electrocardiology. P wave analysis indices (maximum and minimum P wave duration, P wave dispersion [P dis = P max − P min ], adjusted P wave dispersion [AP dis = P dis / √ measured leads], summated P wave duration [P sum ], standard deviation of P wave duration [P sd ], mean P wave duration [Pmean]) can predict atrial arrhythmias. However, the definitions of all these indices are based on few studies. The aim of this analysis was to define normal values of these indices and the examine possible associations between P wave indices and clinical variables. The study included 1,353 healthy men, 24 ± 3 years of age, who answered a questionnaire and underwent a detailed physical examination and a digitized 12-lead surface ECG. All P wave indices were analyzed by two independent investigators. Mean values of the ECG indices were: P max : 96 ± 11 ms, P min : 57 ± 9 ms, P dis : 38 ± 10 ms, P sum : 924 ± 96 ms, P sd : 12 ± 3,AP dis : 11 ± 3 ms, and P mean : 77 ± 8 ms. Age was significantly related with P max (r = 0.277, P < 0.01), P min (r = 0.255, P < 0.001), P sum (r = 0.074, P < 0.01), and P mean (r = 0.074, P < 0.01). All ECG indices were significantly associated with the R-R interval, and among each other. This study defined normal indices of wave duration and correlations among them. These markers may play an important predictive role in patients with atrial conduction abnormalities. (PACE 2003; 26[Pt. II]:367-372)
The Indian journal of medical research, 2012
Morphological abnormalities in 12-lead electrocardiograms (ECGs) are seen in subgroups of healthy individuals like athletes and air-force personnel. As these populations may not truly represent healthy individuals, we assessed morphological abnormalities in ECG in healthy volunteers participating in phase I studies, who are screened to exclude associated conditions. ECGs from 62 phase I studies analyzed in a central ECG laboratory were pooled. A single drug-free baseline ECG from each subject was reviewed by experienced cardiologists. ECG intervals were measured on five consecutive beats and morphological abnormalities identified using standard guidelines. Morphological abnormalities were detected in 25.5 per cent of 3978 healthy volunteers (2495 males, 1483 females; aged 18-76 yr); the presence was higher in males (29.3% vs. 19.2% in females; P<0.001). Rhythm abnormalities were the commonest (11.5%) followed by conduction abnormalities (5.9%), axis deviation (4%), ST-T wave chan...
ECG evaluation in 11 949 Italian teenagers
Journal of Cardiovascular Medicine, 2021
Aim There is lack of evidence regarding the screening role of ECG for sudden cardiac death (SCD) prevention. Our aim was to evaluate the prevalence of ECG abnormalities among teenagers according to sport participation and competitive status. Methods Eleven thousand nine hundred and forty-nine Italian pupils from 179 secondary schools (13-19 years) were consecutively enrolled. ECG abnormalities were divided into minor and major. Medical history, clinical examination and sport activity information were acquired. Further evaluations were suggested in case of major ECG abnormalities. Follow-up was performed at 2 years. Results N U 1945 (16%) pupils had ECG abnormalities. Major ECG abnormalities were detected in 13% of the cohort, minor in 34%. ECG abnormalities were more common in nonathletes compared with athletes. A diagnosis of cardiac disease was reached in 25 (1.6%) of the pupils with major ECG abnormalities. Conclusion ECG abnormalities are common among young populations and more prevalent in nonathletes. Among pupils with major ECG abnormalities 1.6% had a cardiac disease diagnosis. Our results are in line with the data supporting ECG screening in the general young population.
Acta Cardiologica, 2014
adiofrequency (RF) catheter ablation is an established curative therapy for ventricular tachycardias (VT) or symptomatic premature ventricular contractions (PVCs) originating from the outflow tract (OT-VT/PVCs) in structurally normal hearts. 1-13 Although most of these arrhythmias have their origin in the septal aspect of the right ventricular outflow tract (RVOT), 1-9,14 some originate from the free wall of the RVOT. 3,4,14 However, the prevalence and electrocardiographic (ECG) characteristics of idiopathic VT or PVC originating in the free wall of the RVOT have not been sufficiently clarified and the present study was undertaken to determine these. Methods Patient Group The study included 110 patients with symptomatic VT or PVCs who underwent successful RF catheter ablation at the RVOT: 41 men and 69 women, with a mean age of 50±16 years (± SD; range, 21-81 years). During the clinical arrhythmia, the surface ECG showed a left bundle branch block morphology with an inferior axis in all patients. Thirty-four patients had monomorphic VT, defined as 3 or