electrical disease. During preparticipation screening that includes the use of ECG, asymptomatic athletes with any of these abnormal findings should undergo additional testing. Athletes presenting with symptoms (ie, palpitations, exercise, or emotion related syncope or seizure-like activity) should undergo prompt evaluation including an ECG. The evaluation of an athlete with abnormal ECG findings is conducted ideally in consultation with a cardiovascular specialist familiar with primary electrical diseases and with experience caring for athletes. Additional Resources For a free online training module on ECG interpretation in athletes, please visit: http://learning.bmj.com/ECGathlete. For the November 2012 BJSM supplement on ‘Advances in Sports Cardiology’, please visit: http://bjsm.bmj.com/ content/46/Suppl_1.toc. References 1. Ackerman MJ, Priori SG, Willems S, et al. HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm 2011;8:1308–9. 2. Bastiaenen R, Behr ER. Sudden death and ion channel disease: pathophysiology and implications for management. Heart 2011;97:1365–72. 3. Richard P, Denjoy I, Fressart V, et al. Advising a cardiac disease gene positive yet phenotype negative or borderline abnormal athlete: is sporting disqualification really necessary?. Br J Sports Med 2012;46(Suppl 1):i59–68. 4. Maron BJ, Doerer JJ, Haas TS, et al. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation 2009;119:1085–92. 5. Corrado D, Biffi A, Basso C, et al. 12-lead ECG in the athlete: physiological versus pathological abnormalities. Br J Sports Med 2009;43:669–76. 6. Corrado D, Pelliccia A, Heidbuchel H, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur Heart J 2010;31:243–59. 7. Uberoi A, Stein R, Perez MV, et al. Interpretation of the electrocardiogram of young athletes. Circulation 2011;124:746–57. 8. Williams ES, Owens DS, Drezner JA, et al. Electrocardiogram interpretation in the athlete. Herzschrittmacherther Elektrophysiol 2012;23:65–71. 9. Drezner J. Standardised criteria for ECG interpretation in athletes: a practical tool. Br J Sports Med 2012;46(Suppl I):i6–8. 10. Marek J, Bufalino V, Davis J, et al. Feasibility and findings of large-scale electrocardiographic screening in young adults: data from 32,561 subjects. Heart Rhythm 2011;8:1555–9. 11. Drezner JA, Ackerman MJ, Anderson J, et al. Electrocardiographic interpretation in athletes: the ‘Seattle Criteria’. Br J Sports Med 2013;47. 12. Drezner JA, Fischbach P, Froelicher V, et al. Normal electrocardiographic findings: recognizing physiologic adaptations in athletes. Br J Sports Med 2013;47. 13. Schwartz PJ, Stramba-Badiale M, Crotti L, et al. Prevalence of the congenital long-QT syndrome. Circulation 2009;120:1761–7. 14. Tester DJ, Ackerman MJ. Cardiomyopathic and channelopathic causes of sudden unexplained death in infants and children. Annu Rev Med 2009;60:69–84. 15. Eckart RE, Shry EA, Burke AP, et al. Sudden death in young adults an autopsy-based series of a population undergoing active surveillance. J Am Coll Cardiol 2011;58:1254–61. 16. Meyer L, Stubbs B, Fahrenbruch C, et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review. Circulation 2012;126:1363–72. 17. Behr E, Wood DA, Wright M, et al. Cardiological assessment of first-degree relatives in sudden arrhythmic death syndrome. Lancet 2003;362:1457–9. 18. Tester DJ, Spoon DB, Valdivia HH, et al. Targeted mutational analysis of the RyR2-encoded cardiac ryanodine receptor in sudden unexplained death: a molecular autopsy of 49 medical examiner/coroner’s cases. Mayo Clin Proc 2004;79:1380–4. 19. Tan HL, Hofman N, van Langen IM, et al. Sudden unexplained death: heritability and diagnostic yield of cardiological and genetic examination in surviving relatives. Circulation 2005;112:207–13. 20. Tester DJ, Medeiros-Domingo A, Will ML, et al. Cardiac channel molecular autopsy: insights from 173 consecutive cases of autopsynegative sudden unexplained death referred for postmortem genetic testing. Mayo Clin Proc 2012;87:524–39. 21. Gollob MH, Redpath CJ, Roberts JD. The short QT syndrome: proposed diagnostic criteria. J Am Coll Cardiol 2011;57:802–12. 22. Schwartz PJ, Moss AJ, Vincent GM, et al. Diagnostic criteria for the long QT syndrome. An update. Circulation 1993;88:782–4. 23. Schwartz PJ, Crotti L. QTc behavior during exercise and genetic testing for the long-QT syndrome. Circulation 2011;124:2181–4. 24. Viskin S, Rosovski U, Sands AJ, et al. Inaccurate electrocardiographic interpretation of long QT: the majority of physicians cannot recognize a long QT when they see one. Heart Rhythm 2005;2:569–74. 25. Postema PG, De Jong JS, Van der Bilt IA, et al. Accurate electrocardiographic assessment of the QT interval: teach the tangent. Heart Rhythm 2008;5:1015–18. 26. Bazett HC. An analysis of the time-relations of electrocardiograms. Heart 1920; (7):353–70. 27. Johnson JN, Ackerman MJ. The prevalence and diagnostic/prognostic utility of sinus arrhythmia in the evaluation of congenital long QT nummer 5 | november 2013 | Sport & Geneeskunde 33 Pagina 32
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