Early repolarization was present in 14.5% of pediatric athletes, associated with normal ECG adaptations and not linked to abnormal findings, supporting its benign nature.
Early repolarization is a common, benign finding present in approximately 14.5% of healthy pediatric athletes, clustering with other normal training-related ECG adaptations.
Absolute Event Rate: 0% vs 0%
Abstract Introduction Early repolarization (ERP) is an electrocardiographic finding linked to arrhythmic risk in adults, yet often deemed benign in athletes. Its prevalence and characteristics remain underexplored in pediatric populations. We prospectively screened healthy athletes aged 8–17 years participating in "The Escalade race" in Geneva from 2018 to 2024. This study describes the prevalence of ERP, its ECG features, and associated covariates. Methods We enrolled athletes who trained ≥6 hours per week with no known heart disease. Data included demographics, anthropometrics, sports discipline, medical history, blood pressure, heart rate, cardiac auscultation, and 12-lead resting digital ECG performed at least one hour before or after the race. ECGs were interpreted using the 2017 international recommendations and categorized as normal variants, borderline, or abnormal. ERP was identified based on a published consensus (Macfarlane 2015), assessing terminal QRS slurring or notching, location, amplitude, and slur angle. Each ECG was reviewed by a medical student and an experienced cardiologist. Results Among 425 athletes (242 males; mean age 12.7 ± 2.6 years), 77.2% demonstrated normal variants, 6.4% borderline findings, and 1.6% abnormal findings. ERP was present in 14.5%, with no overall sex difference. However, among athletes with ERP, females more frequently exhibited slurred patterns (10.6% vs. 7.0%, p=0.009), while males had more notched patterns (5.6% vs. 0.6%, p=0.019). ERP prevalence did not vary by sports discipline or weekly training hours. It correlated with shorter QRS duration (p=0.018), shorter QTc interval (p=0.002), a lower P axis (p=0.01), and left ventricular hypertrophy (p0.001). It was also associated with the overall presence of normal ECG findings but not with borderline or abnormal findings. Conclusion ERP occurred in about one in seven pediatric athletes and clustered with other normal ECG adaptations, reinforcing its benign nature in this population.
Kane et al. (Sat,) reported a other. Early repolarization was present in 14.5% of pediatric athletes, associated with normal ECG adaptations and not linked to abnormal findings, supporting its benign nature.