Who Should Interpret Screening Preparticipation ECGs in Young Athletes?

Purpose of review: As many physicians include screening ECGs for sports clearance of young athletes, the question arises: who should interpret these ECGs? We provide an overview of who currently interprets these ECGs and offer insight on how to improve this process. Recent findings: Wide variation in training in interpretation of ECGs exists among the providers interpreting screening ECGs of young athletes. The International Criteria is effective at identifying risk and reducing false positives when interpreting ECGs in athletes 12–35 years old, but no standardized training/certification requirements exist. Data is lacking for the use of the International Criteria in athletes outside of these ages. Summary: We propose that licensed physicians with competency utilizing the International Criteria should interpret ECGs in young athletes ages 12–35 years old. It is reasonable to require training/certification as evidence of competency. Patients < 12 or > 35 years old should be considered on a case-by-case basis. Future studies may expand the age parameters. The advancement and use of automated ECG interpretation software and artificial intelligence have the potential to make ECG screening more accurate, cost-effective, and available.