7-011 Electrocardiographic findings of elite British basketball players compared to elite British footballers using the international criteria for ECG interpretation in athletes

Introduction Basketball and football are two sports with the highest incidence of sudden cardiac death (SCD) reported in the literature. Correct identification of high-risk individuals is crucial to reduce the potential of SCD in those harbouring a life-threatening cardiac condition. We sought to describe the ECG characteristics of elite British basketball players and compare the prevalence of ECG abnormalities with a large cohort of elite British football players. Methods A cohort of 310 elite British basketball players at national level (mean age of 18.4 ± 0.9 years) were screened with health questionnaire, ECG and echocardiogram if indicated, between 2021 and 2024. 166 (54%) were male, 148 (48%) were white and 154 (50%) of black ethnicity (African/Caribbean). ECGs were retrospectively analysed according to the International criteria for ECG interpretation in athletes and compared to an age-, ethnicity and sex-matched cohort of elite football players screened through the mandatory Football Association cardiac screening programme. Results 5.2% basketball players were found to have abnormal ECG findings classified by the international criteria compared to 1.8% football players (p <0.0001). Compared to football players, basketball players demonstrated a higher prevalence of abnormal T-wave inversion (TWI) (5.2% vs 1.7%, p <0.0001), abnormal QTc intervals (1% vs 0.3%, p= 0.012), atrial enlargement (4.5% vs 2.2%, p= 0.033), first degree atrioventricular block (6.1% vs 3.2%, p= 0.007) and a greater degree of axis deviation (2.6% vs 1.2%, p= 0.056). Among black athletes, abnormal TWI had equal prevalence in basketball players and football players (4.5% vs 4.1%, p= 1). Black basketball players demonstrated a higher prevalence of right ventricular hypertrophy (2.6% vs 0%, p= 0.141) compared to white counterparts, similar to findings amongst footballers (3.7% vs 2.2%, p= 0.004). White basketball players had a higher prevalence of left ventricular hypertrophy (62.8% vs 55.2% p= 0.218) compared to black counterparts, with similar findings for footballers (24.6% vs 17.2%, p <0.0001). Notably, black basketball players had a lower prevalence of left atrial enlargement (0.6% vs 5.7%, p <0.0001) compared to black footballers. There were no reports of inherited cardiac disease or SCD. Conclusions The International criteria identified ECG abnormalities in 5.2% of elite basketball players compared to 1.8% of elite footballers. This study highlights the higher false-positive rates of the ECG among basketball players and that sport-specific ECG criteria should be used to improve the diagnostic rate for cardiac disease in order to optimise cardiovascular care for all subgroups of athletes.