An abnormal electrocardiogram (ECG) is common among young athletes but the underlying cause is unclear. Therefore it is hard to predict how accurate ECG is when screening for sudden cardiac death (SCD) in elite athletes.

Objective: 1) to determine the prevalence of abnormal ECG patterns, among soccer players, especially in relation to age and 2) to link  ECG patterns with echocardiographic findings in order to find out whether the ECG can predict disease and/or physiological changes.

Materials and methods: A total of 159 male soccer players (16-45 years, mean age 25.5 years)  that participated in the UEFA cup competition 2008-2010 were studied. They underwent both an ECG  and echocardiography along with routine history and cardiologic examination, according to UEFA protocol. Results were classified and grouped according to standards set by The European Society of Cardiology and The American Society of Echocardiography.

Results: 84 (53%) had abnormal ECG patterns. The prevalence of abnormal ECG patterns decreased with age. Echocardiographic findings showed that left ventricular wall thickness, mass and diameter increased with age, along with left atrial diameter. Left ventricular wall thickness, diameter and mass were similar among those with an abnormal ECG and those with a normal ECG. 

Conclusion: The prevalence of abnormal ECG´s is high in Icelandic soccer players, a finding that usually does not indicate underlying heart disease.  There was no relationship between ECG changes and echocardiographic findings.  High prevalance of abnormal ECG patterns in young athletes reduces the usefulness of ECG in screening for SCD.

Key words: sudden death in athletes, soccer players, electrocardiography, echocardiography, screening

Correspondence: Axel F. Sigurðsson, axel@hjartamidstodin.is

1Department of Life Sciences, University of Iceland, 2Heart Center, 3Department of Cardiology, The National University Hospital of Iceland, 4Læknasetrið