Comparison of the ‘Seattle’ and ‘International’ Criteria Electrocardiogram Interpretation in Division II Female Collegiate Athletes: A Preliminary Study

Abstract

Purpose

A 12-lead electrocardiogram (ECG) is a screening tool to detect abnormalities that may predispose athletes to sudden cardiac death. Newer standardized criteria have been introduced to better interpret ECG data, however this research has predominantly focused on male athletes. It is important to include female athletes in research to better define ECG characteristics in this population. The purpose of this study was to compare the Seattle and International Criteria ECG abnormalities in Division II female collegiate athletes of various ethnicities.

Methods

Fifty-six females (age 20.2 ± 1.4 years; height 1.70 ± 0.7 m; weight 69.5 ± 8.9 kg) completed a resting 12-lead ECG protocol. ECG data was classified as ‘normal’ and ‘abnormal’ according to the parameters of each criterion and abnormal conditions were noted. Chi-square analysis was used to assess statistical comparisons between criteria.

Results

There was a significant difference in abnormal classifications as the total number of ECGs identified as abnormal using the Seattle Criteria decreased from 12 (21.4%) to 2 (3.6%) when using the International Criteria (P < 0.05). African American athletes had a higher number of abnormal ECG’s compared to White and Latina athletes using the Seattle Criteria (P = 0.03).

Conclusions

The International Criteria significantly reduces the total number of abnormal ECG readings in female collegiate athletes compared to the Seattle Criteria and did not overly identify African American athletes with abnormalities. Further research is necessary to expand on this study and clearly define criteria for female athletes of various ethnicities.