Key result
Elite athletic training is linked to a ~34% higher mean QRST integral on single-lead ECG.
Why the study?
Basic resting ECG changes from intense exercise characterize the athlete's heart, but detailed short-term ECG analysis was needed to evaluate electrocardiographic, heart rate variability, and ventricular heterogeneity changes relative to factors influencing sports adaptation.
Does a 1-minute lead I ECG recording detect electrical differences (standard ECG, HRV, QRST integral) between elite athletes and non-athlete controls?
Cross-Sectional (n=600)
No
Does a 1-minute lead I ECG recording detect electrical differences (standard ECG, HRV, QRST integral) between elite athletes and non-athlete controls?
A simple 1-minute lead I ECG recording can effectively detect key electrical sports adaptation markers, including standard ECG parameters, HRV, and ventricular heterogeneity, differentiating elite athletes from non-athletes.
Answers are grounded in this paper and cite their sources.
1-min lead I ECG may detect athletic adaptations; hypothesis-generating and needs prospective validation before screening use.
Background Basic resting electrocardiographic changes caused by regular intense exercise are known characteristics of the athlete’s heart. Through detailed analysis of short-term ECG recordings, our aim was to study electrocardiographic, heart rate variability, and ventricular heterogeneity changes of the athlete’s heart as a function of factors influencing sports adaptation. Methods Analysis of 1-minute resting lead I ECG recordings was used to determine standard ECG parameters, time-domain indicators of heart rate variability, and mean and standard deviation of QRST integrals. Statistical analysis was performed in Python development environment. Results 500 healthy athletes (age: 19[16–24]y, male: 55%, training: 16.7 ± 6.5 h/w) were compared with 100 non-athlete controls (age: 21[17–23]y, male: 51%). Athletes had lower heart rate (68[61–78]vs.82[73–91]BPM, p < 0.001), increased p-wave amplitude (89[71–108]vs.80[62–96]µV, p < 0.001), PQ interval (152[140–168]vs.142[132–152]ms, p < 0.001), QRS width (90[82–100]vs.82[78–90]ms, p < 0.001), T-wave amplitude (257[198–311]vs.195[146–248]µV, p < 0.001), SDNN (64.7[47.2–87.2]vs.50.6[36.5–66.3]ms, p < 0.001), RMSSD (52.6[34.8–78.3]vs.36.4[26.8–52.6]ms, p < 0.001), pNN50 (31.1[12.7–50.9]vs.14.7[4.9–31.6]%, p < 0.001) and mean QRST integral (34.9[28.3–43.4]vs.26.1[19.7–33.9]mV*ms, p < 0.001) compared to controls. Mixed athletes had wider QRS compared to power athletes (94[90–102]vs.88[84–96]ms, p < 0.005). Male athletes had lower QTc, increased PQ interval, QRS width, T-wave amplitude, mean QRST integral, and its deviation. In the control group, females had higher resting heart rate and QTc duration, while AVNN and the relative deviation of QRST integral were lower. Many of the above parameters also showed weak correlation with age and weekly exercise hours. Conclusions Our findings indicate that a 1-minute lead I ECG recording can detect electrical differences between athletes and non-athlete controls and may provide a practical framework for future longitudinal studies of athletic cardiac adaptation.
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Boroncsok et al. (2026) conducted a cross-sectional in Healthy (sports adaptation) (n=600). Elite athletic training vs. Non-athlete controls (<5 hours/week training) was evaluated on Mean QRST integral (mV*ms) (p=<0.001). Elite athletic training was associated with significant electrical cardiac adaptations detectable on a 1-minute lead I ECG, including lower resting heart rate (68 vs 82 BPM) and increased mean QRST integral (34.9 vs 26.1 mV*ms) compared to controls.
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