ECG interpretation in athletes is a required skill for the sports medicine physician. Whether used for screening or diagnostic purposes, ECG facilitates the detection of conditions at risk for sudden cardiac death (SCD). ECG interpretation standards have evolved over the last decade as scientific studies improved the division of physiological from pathological ECG changes. The Seattle Criteria (2013) provided consensus recommendations by an international panel of experts in sports cardiology and emerged as a practical guideline to improve ECG interpretation accuracy.1 In 2017, the International Criteria was released by the same expert panel and intended to supersede prior guidelines as the current standard for ECG interpretation in athletes.2 Each revision of ECG standards has improved specificity without compromising sensitivity for ECG-detectable pathological conditions associated with SCD.3–5 In a cohort of 5258 college athletes from the USA, application of the International Criteria lowered the false-positive rate compared with the Seattle Criteria from 2.8% to just 1.3%.3 Likewise, in a cohort of 11 168 adolescent soccer players from the UK, the total number of athletes with an abnormal ECG was reduced 57% by moving from the Seattle Criteria (4.3%) to the International Criteria (1.8%).4 The most substantive change is the introduction of a ‘yellow’ box or list of borderline ECG findings in which two or more borderline findings …

中文翻译：

---

运动员心电图解读国际标准的 18 个要点

运动员心电图解读是运动医学医师的必备技能。无论是用于筛查还是诊断目的，心电图都有助于检测心源性猝死 (SCD) 的风险。随着科学研究改进了生理性和病理性心电图变化的划分，心电图解释标准在过去十年中不断发展。西雅图标准 (2013) 提供了运动心脏病学国际专家小组的共识建议，并成为提高心电图解读准确性的实用指南。1 2017 年，同一专家小组发布了国际标准，旨在取代之前的指南作为运动员心电图解读的现行标准。2 心电图标准的每次修订都提高了特异性，同时又不影响心电图可检测到的与 SCD 相关的病理状况的敏感性。3-5 在美国 5258 名大学运动员的队列中，应用了国际标准与西雅图标准相比，该标准将假阳性率从 2.8% 降低至仅 1.3%。3 同样，在由 11 168 名英国青少年足球运动员组成的队列中，心电图异常的运动员总数减少了 57%从西雅图标准 (4.3%) 转向国际标准 (1.8%)。4 最实质性的变化是引入“黄色”框或边缘心电图结果列表，其中两个或多个边缘结果……