Several electrocardiographic changes can be seen in athletes which should alert a physician to the presence of an underlying electrical disorder. The Seattle criteria are from a meeting of the American Medical Society for Sports Medicine, FIFA and other organizations that met in Seattle in 2012.
ECG changes that may be associated with an underlying primary electrical disorder:
(1) ventricular pre-excitation (PR interval < 120 ms with a delta wave and wide QRS > 120 ms)
(2) long QT interval (QTc in male >= 470 ms, QTc in female >= 480 ms)
(3) short QT interval (QTc <= 320 ms)
(4) Brugada-like ECG pattern (high-take off and downsloping ST segment elevation followed by a negative T wave in >= 2 leads in V1 to V3)
(5) profound sinus bradycardia (< 30 beats per minute OR sinus pauses >= 3 seconds)
(6) atrial tachyarrhythmias (supraventricular tachycardia, atrial fibrillation, atrial flutter)
(7) premature ventricular contractions (PVCs, 2 or more in a 10 second tracing)
(8) ventricular arrhythmias (including couplets, triplets and non-sustained ventricular tachycardia)
where:
• The last 2 ECG changes can also be seen in cardiomyopathies.
