This consensus statement defines and revises ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

Cardiovascular-related sudden death is the leading cause of mortality in athletes during sport and exercise. The majority of disorders associated with an increased risk of sudden cardiac death (SCD), such as cardiomyopathies and primary electrical diseases (channelopathies), are suggested or identified by abnormalities present on a resting 12-lead ECG. Interpretation of an ECG in athletes requires careful analysis to properly distinguish physiological changes related to athletic training from findings suggestive of an underlying pathological condition. Whether used for the evaluation of cardiovascular-related symptoms, a family history of inheritable cardiac disease or premature SCD, or for screening of asymptomatic athletes, ECG interpretation is an essential skill for all physicians involved in the cardiovascular care of athletes.