Resting electrocardiogram in junior athletes: peculiarities of definition and interpretation
| ECG . | Definition . |
|---|---|
| Normal ECG findings | |
| Juvenile T-wave pattern | T-wave inversion V1–V3 in athletes <16 years |
| I degree AV block | PR interval longer than 200 msec but shorter than 300 msec |
| Increased QRS voltage | Isolated QRS voltage criteria for left (SV1 + RV5 or RV6 > 3 mVa) or right ventricular hypertrophy (RV1 + SV5 or SV6 > 0.8 mV) |
| Borderline ECG findings | |
| Incomplete RBBB | rSR′ pattern in lead V1 and a qRS pattern in lead V6 with QRS duration <100 ms |
| Left axis deviation | −9° to −90° |
| Right axis deviation | >110° |
| Abnormal ECG findings | |
| Short PR interval | PR interval ≤90 ms |
| Complete RBBB | rSR′ pattern in lead V1 and an S wave wider than R wave in lead V6 with QRS duration ≥100 ms |
| Complete LBBB | QRS ≥100 ms, predominantly negative QRS complex in lead V1 (QS or rS) and upright notched or slurred R wave in leads I and V6 |
| Prolonged QT interval | QTc ≥470 msec in high-level junior athletes |
| QTc ≥460 msec | |
| Profound sinus bradycardia | <40 beats per minute or sinus pauses ≥3 s |
| Ventricular pre-excitation | PR interval ≤90 msec with a delta wave (slurred upstroke in the QRS complex) and wide QRS (≥90 ms) |
| Profound, non-specific intraventricular conduction delay | Any QRS duration ≥130 ms |
| Profound 1° AV block | PR interval ≥300 ms |
| T-wave inversion | ≥1 mm in depth in two or more contiguous leads, excluding leads aVR, III, and V1 |
| – Anterior | V2–V4 |
| – excludes: black athletes with J-point elevation and convex ST segment elevation followed by TWI in V2–V4; athletes < age 16 with TWI in V1–V3; and biphasic T waves in only V3 | |
| – Lateral | I and aVL, V5 and/or V6 (only one lead of TWI required in V5 or V6) |
| – Inferolateral | II and aVF, V5–V6, I and aVL |
| – Inferior | II and aVF |
| ECG . | Definition . |
|---|---|
| Normal ECG findings | |
| Juvenile T-wave pattern | T-wave inversion V1–V3 in athletes <16 years |
| I degree AV block | PR interval longer than 200 msec but shorter than 300 msec |
| Increased QRS voltage | Isolated QRS voltage criteria for left (SV1 + RV5 or RV6 > 3 mVa) or right ventricular hypertrophy (RV1 + SV5 or SV6 > 0.8 mV) |
| Borderline ECG findings | |
| Incomplete RBBB | rSR′ pattern in lead V1 and a qRS pattern in lead V6 with QRS duration <100 ms |
| Left axis deviation | −9° to −90° |
| Right axis deviation | >110° |
| Abnormal ECG findings | |
| Short PR interval | PR interval ≤90 ms |
| Complete RBBB | rSR′ pattern in lead V1 and an S wave wider than R wave in lead V6 with QRS duration ≥100 ms |
| Complete LBBB | QRS ≥100 ms, predominantly negative QRS complex in lead V1 (QS or rS) and upright notched or slurred R wave in leads I and V6 |
| Prolonged QT interval | QTc ≥470 msec in high-level junior athletes |
| QTc ≥460 msec | |
| Profound sinus bradycardia | <40 beats per minute or sinus pauses ≥3 s |
| Ventricular pre-excitation | PR interval ≤90 msec with a delta wave (slurred upstroke in the QRS complex) and wide QRS (≥90 ms) |
| Profound, non-specific intraventricular conduction delay | Any QRS duration ≥130 ms |
| Profound 1° AV block | PR interval ≥300 ms |
| T-wave inversion | ≥1 mm in depth in two or more contiguous leads, excluding leads aVR, III, and V1 |
| – Anterior | V2–V4 |
| – excludes: black athletes with J-point elevation and convex ST segment elevation followed by TWI in V2–V4; athletes < age 16 with TWI in V1–V3; and biphasic T waves in only V3 | |
| – Lateral | I and aVL, V5 and/or V6 (only one lead of TWI required in V5 or V6) |
| – Inferolateral | II and aVF, V5–V6, I and aVL |
| – Inferior | II and aVF |
AV, atrioventricular; LBBB, left bundle branch block; RBBB, right bundle branch block; TWI, T-wave inversion.
Reference values may differ according to sex.
Resting electrocardiogram in junior athletes: peculiarities of definition and interpretation
| ECG . | Definition . |
|---|---|
| Normal ECG findings | |
| Juvenile T-wave pattern | T-wave inversion V1–V3 in athletes <16 years |
| I degree AV block | PR interval longer than 200 msec but shorter than 300 msec |
| Increased QRS voltage | Isolated QRS voltage criteria for left (SV1 + RV5 or RV6 > 3 mVa) or right ventricular hypertrophy (RV1 + SV5 or SV6 > 0.8 mV) |
| Borderline ECG findings | |
| Incomplete RBBB | rSR′ pattern in lead V1 and a qRS pattern in lead V6 with QRS duration <100 ms |
| Left axis deviation | −9° to −90° |
| Right axis deviation | >110° |
| Abnormal ECG findings | |
| Short PR interval | PR interval ≤90 ms |
| Complete RBBB | rSR′ pattern in lead V1 and an S wave wider than R wave in lead V6 with QRS duration ≥100 ms |
| Complete LBBB | QRS ≥100 ms, predominantly negative QRS complex in lead V1 (QS or rS) and upright notched or slurred R wave in leads I and V6 |
| Prolonged QT interval | QTc ≥470 msec in high-level junior athletes |
| QTc ≥460 msec | |
| Profound sinus bradycardia | <40 beats per minute or sinus pauses ≥3 s |
| Ventricular pre-excitation | PR interval ≤90 msec with a delta wave (slurred upstroke in the QRS complex) and wide QRS (≥90 ms) |
| Profound, non-specific intraventricular conduction delay | Any QRS duration ≥130 ms |
| Profound 1° AV block | PR interval ≥300 ms |
| T-wave inversion | ≥1 mm in depth in two or more contiguous leads, excluding leads aVR, III, and V1 |
| – Anterior | V2–V4 |
| – excludes: black athletes with J-point elevation and convex ST segment elevation followed by TWI in V2–V4; athletes < age 16 with TWI in V1–V3; and biphasic T waves in only V3 | |
| – Lateral | I and aVL, V5 and/or V6 (only one lead of TWI required in V5 or V6) |
| – Inferolateral | II and aVF, V5–V6, I and aVL |
| – Inferior | II and aVF |
| ECG . | Definition . |
|---|---|
| Normal ECG findings | |
| Juvenile T-wave pattern | T-wave inversion V1–V3 in athletes <16 years |
| I degree AV block | PR interval longer than 200 msec but shorter than 300 msec |
| Increased QRS voltage | Isolated QRS voltage criteria for left (SV1 + RV5 or RV6 > 3 mVa) or right ventricular hypertrophy (RV1 + SV5 or SV6 > 0.8 mV) |
| Borderline ECG findings | |
| Incomplete RBBB | rSR′ pattern in lead V1 and a qRS pattern in lead V6 with QRS duration <100 ms |
| Left axis deviation | −9° to −90° |
| Right axis deviation | >110° |
| Abnormal ECG findings | |
| Short PR interval | PR interval ≤90 ms |
| Complete RBBB | rSR′ pattern in lead V1 and an S wave wider than R wave in lead V6 with QRS duration ≥100 ms |
| Complete LBBB | QRS ≥100 ms, predominantly negative QRS complex in lead V1 (QS or rS) and upright notched or slurred R wave in leads I and V6 |
| Prolonged QT interval | QTc ≥470 msec in high-level junior athletes |
| QTc ≥460 msec | |
| Profound sinus bradycardia | <40 beats per minute or sinus pauses ≥3 s |
| Ventricular pre-excitation | PR interval ≤90 msec with a delta wave (slurred upstroke in the QRS complex) and wide QRS (≥90 ms) |
| Profound, non-specific intraventricular conduction delay | Any QRS duration ≥130 ms |
| Profound 1° AV block | PR interval ≥300 ms |
| T-wave inversion | ≥1 mm in depth in two or more contiguous leads, excluding leads aVR, III, and V1 |
| – Anterior | V2–V4 |
| – excludes: black athletes with J-point elevation and convex ST segment elevation followed by TWI in V2–V4; athletes < age 16 with TWI in V1–V3; and biphasic T waves in only V3 | |
| – Lateral | I and aVL, V5 and/or V6 (only one lead of TWI required in V5 or V6) |
| – Inferolateral | II and aVF, V5–V6, I and aVL |
| – Inferior | II and aVF |
AV, atrioventricular; LBBB, left bundle branch block; RBBB, right bundle branch block; TWI, T-wave inversion.
Reference values may differ according to sex.
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