Article Title



Ludmila Cosio Lima, FACSM, Lauren Adlof, Amy Crawley, Youngil Lee. University of West Florida, Pensacola, FL.

PURPOSE: A 12-lead exercise stress test is a screening tool used to detect abnormalities that may predispose collegiate athletes to sudden cardiac death. Experts in the field have developed new standardized criteria to better interpret electrocardiogram (ECG) in athletes. Recent research suggests that African American athletes are more prone to cardiac abnormalities. The purpose of this study was to evaluate the sensitivity and specificity of the Seattle Criteria to the most recently created International Criteria in regard to ECG abnormalities in Division II African-American collegiate athletes. METHODS: Forty four African American male athletes (football, basketball, soccer) (age 22.2 +1.4 yrs; height 1.82 +0.1 m; weight 88.8 + 14.9 kg) completed cardiovascular screening with a resting 12-lead ECG analysis which was read and interpreted, according to each criterion, by an expert in the field of exercise science. ECGs were classified as ‘normal’ and ‘abnormal’ according to the parameters of each criterion, and any abnormal condition was noted. The sensitivity and specificity of both criteria were computed. RESULTS: There was no significant difference in the sensitivity between both criteria (98.1%-100%). The International Criteria was more specific than the Seattle Criteria (91.2-94.1% vs. 87.4-88.2%). Applying the International Criteria when evaluating African American college athletes resulted in a significant decrease in abnormal ECGs and improvement of the positive predictive value of an abnormal ECG. CONCLUSIONS: These results demonstrated that following the International Criteria for ECG interpretation significantly reduced the total abnormal and false-positive ECG rates in African American collegiate athletes compared to the Seattle Criteria without compromising sensitivity. It is important to continue to conduct ECG research on athletes of different ethnicities and races in order to further define valid and reliable criteria for this underrepresented population.

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