641 MEP178 – Screening for cardiac arrhythmia with the single-lead wearable ECG monitoring during the endurance exercise in athletes

AbstractBackgroundPre-screening is crucial for athletes to reduce the risk of sudden cardiac death (SCD). However, 12 lead ECG screening alone is insufficient to prevent SCD. Objective This study aims to determine the feasibility of using wearable electrocardiogram (wearable-ECG) during endurance exercises. Additionally, it intends to assess the effectiveness of wearable-ECG in detecting cardiac arrhythmias that may arise during exercise.Design This prospective observational study focused on wearable ECG for endurance athletes.Setting Before and after the exercise, all athletes underwent 12-lead ECGs and routine laboratory tests. Throughout a 3-hour endurance training course, participants were equipped with both wearable-ECG and heart rate trackers featuring photoplethysmography sensors (PPG-tracker).Participants The study included total sixteen endurance athletes, 6 cyclists and 10 runners, all of whom were Korean males, with an average age of 43±7 years.Intervention Participants were equipped with both PPG-trackers and wearable-ECGs throughout the entire training session, from warm-up to cool-down.Primary Outcomes Heart rate trends and the detection of arrhythmias using wearable-ECG were compared to those obtained from the PPG-tracker. Results Both the wearable-ECG and PPG-tracker effectively recorded heart rate trends during exercise for all participants (6 out of 6 cyclists and 8 out of 10 runners, r=0.978). However, there were instances where two runners intermittently failed to record heart rate and ECG due to detachment issues with the wearable-ECG (2 out of 10 athletes). Notably, only the wearable-ECG could reliably identify significant arrhythmias during exercise. Wearable-ECG detected premature ventricular contractions in two athletes (one during rest and the other during exercise), whereas the PPG-tracker failed to identify these abnormalities.Conclusion The wearable-ECG monitoring during endurance exercises such as cycling and running is a highly feasible and superior method for early detection of cardiac arrhythmias in athletes. Such evaluations could potentially prevent unforeseen events, such as sudden cardiac death.Download figure Open in new tab Download powerpoint Abstract 641 Figure 1