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June 12, 2026European Journal of Preventive CardiologyOpen Access

Anterior TWI in V1–V2 was the most common finding (78.2%), present in 89.8% of females and 70.9% of males, while early repolarisation was found in 43.9% and incomplete RBBB in 54% of athletes.

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Population

307 competitive athletes representing 8 sports undergoing annual pre-participation cardiovascular screening…

Design

Cohort

Authors

HAH Alhaj AliAKA F KteilRGR I Gabulova

Discussion

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Overview

ECG patterns vary by sport/sex in athletes; extends descriptive data but leaves open screening impact and needs prospective validation.

Key Points

  • This study aims to describe the prevalence of specific ECG patterns related to sex and sport type in competitive athletes.
  • Retrospective analysis of 307 athletes across 8 sports involved in pre-participation cardiovascular screening from 2019 to 2024.
  • Assessment included family history, physical examination, resting ECG, and echocardiography, excluding those with known cardiovascular disease.
  • Descriptive analysis conducted on ECG findings categorized by sex and sport type.
  • Anterior T wave inversion was observed in 78.2% of athletes, with higher prevalence in volleyball (95.6%) and lower in wrestling (46.2%).
  • Early repolarisation pattern present in 43.9% of athletes, more common in males, with weightlifting showing 21.3%.
  • Incomplete right bundle branch block was found in 54% of athletes, predominantly in males (22%) and footballers (43%).

Structured PICO

P
Population
307 competitive athletes representing 8 sports (wrestling n=13, karate n=31, judo n=31, weightlifting n=75, gymnastics n=64, football n=14, volleyball n=68, rowing n=11) undergoing annual pre-participation cardiovascular screening between 2019 and 2024. Mean age 21.7±5.9, 38.4% female. Excluded: known cardiovascular disease or symptoms suggestive of cardiovascular pathology.
I
Intervention
Resting 12-lead ECG and echocardiography as part of pre-participation cardiovascular screening
O
Outcome
Prevalence of commonly seen ECG changes: T wave inversion (TWIs), Early repolarisation (ER), Incomplete right bundle branch block (iRBBB), and fragmented QRS (fQRS)surrogate

ECG variations in conduction and repolarisation patterns among competitive athletes are significantly influenced by the type of sport and sex, highlighting the need for sport- and sex-specific interpretive criteria.

Cite This Study

Ali et al. (2026) studied this question.

synapsesocial.com/papers/6a2bd11d6550ea4541ffe912https://doi.org/10.1093/eurjpc/zwag249.384
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