Characteristics of resting ECG among Sabah professional male footballers

Abstract

The purpose of this study is to describe the resting electrocardiogram (ECG) seen among 176 professional male footballers from Sabah Football Association Club during preparticipation evaluation. Data were analysed retrospectively from 2017 to 2019. Majority of the players were Sabah natives (n=153, 87%) while the remaining were Malay footballers (n=23, 13%). Mean age of the players was 19.9 ± 3.1, mean body mass index was 22.6 kg/m2 ± 7, mean resting heart rate was 53.6 beats per minute ± 9.4, mean systolic blood pressure was 122.3 mmHg ± 12, and mean diastolic blood pressure was 65.1 mmHg ± 8.8. Using the International Criteria for ECG Interpretation in Athletes 2017 consensus guidelines, 8.5% (n=15) had abnormal ECG while 2.8% (n=5) had borderline ECG. The most common ECG changes seen in the normal findings were sinus bradycardia (n=123, 69.9%), early repolarization (n=115, 65.3%) and left ventricular hypertrophy (n=83,47.2%). Abnormal ECGs were abnormal t wave inversion (n=7,4.0%) and pre-excitation syndrome (n=5,2.9%). All footballers with abnormal ECG findings were subjected to further evaluation by a cardiologist using echocardiography assessment and exercise stress test. They passed the cardiology assessment; thus, they were deemed fit to play. ECG is a valuable tool for pre-participation health screening prior to exercise or sports participation, as it is vital for a physician to identify any abnormal ECG to minimise the risk of sudden cardiac death during exercise due to cardiac pathology.