Author(s): STOIAN, I., IONESCU, A., GEORGESCU, M., STOIAN, N., Institution: STOIAN I. IOANA MARINA - MEDIC PRIMAR CARDIOLOGIE, Country: ROMANIA, Abstract-ID: 1421

INTRODUCTION:
Introduction.Pre-Participation (PPE) exams (clinical,12 lead electrocardiography, ECG) detect cardiac abnormalities, some of them responsible of sudden cardiac death (SCD) occurring in 90% cases, during or immediately after exercise(3).Electrical adaptation to exercise and the similarity with cardiac anomalies are a well-known phenomenon(2);the diagnosis implies comprehensive tests for detecting cardiac pathology.In certain cases, asymptomatic athletes (ath) have ECG anomalies, regarded as “isolated” when endorse by negative results of complex tests for cardiac disorder detection (1).Can the ath continue their competitive work? Do they need medical reassessment?
METHODS:
Method.Retrospective Study,10 years (2015-2025), highly trained ath.
Pre-Participation (PPE)(annually) all ath.
“Isolated electrical abnormalities“ stand for ECG findings suggestive of cardiac pathologies, not accompanied by a personal/ family history indicating a cardiac disease, in the absence of any pathological findings on First-Line investigations(1).
a) Pre-Test: symptoms;family history;gender;ethnicity;training type/intensity.
b) 12 lead ECG (2)
c) 12 lead ECG “Isolated electrical abnormalities”:sinus bradycardia (< 30 bpm);marked
(> 400 ms) PR int;daytime AV block gr.II (type I);right bundle branch block (RBBB;QRS  130 ms);left bundle brunch block (LBBB);complex premature ventricular beats (burden >10% ); Brugada 2/3;invert T wave (V1-V6.(1)
d) First-Line Tests: blood; ambulatory ECG; exercise testing; echocardiography.(1)
e) Second-Line Tests: cardiac magnetic- resonance, coronary angiography CT when indicated.(1)

RESULTS:
Results: 1832 ath, PPE 2015-2025. Study Group: 404 professional football, received cardiologic exams (17-36 yo;males 100%;caucasian 60%, black 40%; height 178+-2 cm;weight 73+-2 kg.BP 115+- 5/60 +-2 mmHg.
A.Asymptomatic, 360 (89.1%): Gr.I: 302 (83.8%), normal clinic and 12 lead ECGs.
Gr II: 58 (16.1%) ”Isolated 12 lead ECG abnormalities”-(invert Twave V1-V6, 20; invert T wave D2,D3,aVF, 4; AV I (>400ms) + AV II type I, 6; RBBB (>130ms), 6; left fascicular + AV I, 4; Brugada sign 2/3, 8;severe sinus bradycardia, 4;complex PVB, 6) were associated with normal First-Line or Second-Line tests.
B) Symptomatic (palpitations,chest pain) in 44 (10.89%) during exercise.Complex cardiac conditions diagnosed by specific tests.Postponed intense exercise and competitions.

CONCLUSION:
Discussion.In our study, most ath (Gr.I) were free of symptoms and had normal ECGs. A small group (Gr.II) of asymptomatic ath. had 12-lead ECGs anomalies which proved to be isolated, according to the normal data of the First/Second-Line tests. All asymptomatic Gr.II ath.returned to play and consider annual medical check-up. No incidents recorded in 10 years follow-up.
Conclusion. Asymptomatic athletes with “Isolated electrical abnormalities“associated with normal clinical findings, normal First-Line/Second-Line tests, can continue playing in competitive sports, counseling of regular follow-up .