Impact of early sports specialisation on paediatric ECG

Athletes of paediatric age are growing in number. They are subject to a number of risks, among them Sudden Cardiac Death (SCD). This study aimed to characterise the paediatric athlete population in Switzerland; to evaluate electrocardiographic findings based on the International Criteria for ECG Interpretation in Athletes and to analyse the association between demographic data, sport type and ECG changes. Retrospective, observational study of paediatric athletes (less than 18 years old) including medical history, physical examination and a 12-lead resting ECG. The primary focus was on identification of normal, borderline and abnormal ECG findings. The secondary observation was the relation between ECG and demographic, anthropometric, sport-related and clinical data. The 891 athletes (mean 14.8 years, 35% girls) practised 45 different sports on three different levels, representing all types of static and dynamic composition of the Classification of Sports by Mitchell. There were 75.4% of normal ECG findings, among them most commonly early repolarisation, sinus bradycardia and left ventricular hypertrophy; 4.3% had a borderline finding; 2.1% were abnormal and required further investigations, without SCD-related diagnosis. While the normal ECG findings were related to sex, age and endurance sports, no such observation was found for borderline or abnormal criteria. Our results in an entirely paediatric population of athletes demonstrate that sex, age and type of sports correlate with normal ECG findings. Abnormal ECG findings in paediatric athletes are rare. The International Criteria for ECG Interpretation in Athletes are appropriate for this age group.