Trained hearts adapt. Findings that would prompt investigation in a sedentary adult - sinus bradycardia, early repolarisation, isolated voltage criteria for left ventricular hypertrophy - are expected in trained athletes and are not, on…
Trained hearts adapt. Findings that would prompt investigation in a sedentary adult - sinus bradycardia, early repolarisation, isolated voltage criteria for left ventricular hypertrophy - are expected in trained athletes and are not, on their own, a concern. Reading athlete ECGs against general population norms produces large numbers of false positives, unnecessary alarm and unnecessary cost. We use international athlete-specific interpretation criteria.
Whether ECG should be added to history and physical for all athletes is genuinely contested. Several international bodies recommend it; major United States bodies have not universally endorsed it, citing false positives, cost and downstream testing. We offer it, we think it adds value when read properly, and we think you are entitled to know the argument rather than be sold a settled answer that does not exist.
The athlete is not cleared that day and is referred for echocardiography or a sports cardiology opinion. We give the athlete and their family the tracing and the interpretation to take with them, because arriving at a specialist empty-handed wastes an appointment. Most referred athletes are ultimately cleared.
The intervention with the strongest evidence behind it is not screening - it is an accessible AED, a rehearsed emergency action plan, and people on site trained in CPR. If a programme has to choose, choose those first. We will say so even when it means selling less.
Primary regulations and standards referenced above. Where a standard is published commercially it is named in full rather than linked to a copy.