Different patterns of pre-excitation in a large Italian cohort of asymptomatic non-competitive athletes evaluated by telecardiology screening: Prevalence and ECG features

Abstract

Background: Telecardiology has proven to be a useful and cost-effective tool for ECG screening in several contexts, allowing the evaluation of large cohorts of subjects in a short time, even for non-competitive athletes (NCA). Aim of the study: To evaluate and detail the prevalence of the Wolff-Parkinson-White (WPW) syndrome in a large Italian cohort of young NCA. Methods: In a 4-year period 216,424 consecutive NCA (118,851 males; 55%) underwent preparticipation ECG screening through a Telecardiology System. ECGs were recorded and sent by a network of ‘spoke’ centers located all over Italy; a ‘hub’ center, located in Genoa, received and reported back on ECGs, digitally stored and analyzed. Only asymptomatic NCA were included in the study. Results: Out of 216,424 NCA 88 (mean age: 14 ± 8) presented a WPW pre-excitation at ECG analysis (55 males, 62.5 %); the prevalence of WPW pre-excitation in this population was 4.1 per 10,000 NCA. No significant sex-related differences were found. The highest incidence (29 WPW patterns) was observed in the 10–15 year group with an equal sex ratio (M/F:16/13).Intermittent pre-excitation was found in 8 NCAs. The most frequent accessory pathway locations were right antero-septal (25.0%), mid-septal (21.6%) and postero-septal (13.6%). Conclusions: In a large population of young NCA the prevalence of ECG pre-excitation at telemedicine remote screening was 4.1 per 10,000; intermittent pre-excitation was found in 9% of NCA with ECG pre-excitation.

Keywords

• Wolff-Parkinson-White
• Non-Competitive Athletes
• Telemedicine
• Telecardiology
• Electrocardiogram
• Screening