January 2025
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24 Reads
Sports
Citation: Climstein, M.; Graham, K.S.; Stapelberg, M.; Walsh, J.; DeBeliso, M.; Adams, K.; Sevene, T.; Harris, C. Electrocardiographic Assessment of National-Level Triathletes: Sinus Bradycardia and Other Electrocardiographic Abnormalities. Sports 2025, 13, 25. Abstract: Background: High-intensity endurance training induces specific cardiac adaptations , often observed through electrocardiographic (ECG) changes. This study investigated the prevalence of ECG abnormalities in national-level Australian triathletes compared to sedentary controls. Methods: A cross-sectional observational study was conducted involving 22 triathletes and 7 sedentary controls. Standard 12-lead ECGs assessed resting heart rate, ECG intervals, and axis deviation. Peak oxygen consumption was evaluated in triath-letes to correlate with ECG indices and left ventricular mass, derived via echocardiography. Results: Triathletes exhibited significantly lower resting heart rates (53.8 vs. 72.1 bpm, −34%, p = 0.04), shorter QRS durations (0.088 vs. 0.107 ms, −21.6%, p = 0.01), and longer QT intervals (0.429 vs. 0.358 ms, +16.6%, p = 0.01) compared to controls. Sinus bradycardia was present in 68.2% of triathletes, with varying severity. First-degree atrioventricular block was identified in 13.6% of athletes, and left ventricular hypertrophy was confirmed in 18 triathletes via echocardiography. A significant positive relationship was identified between VO 2 peak and left ventricular mass (r = 0.68, p = 0.003). Conclusions: National-level triathletes exhibited ECG and structural cardiac adaptations consistent with high-intensity endurance training. Echocardiography is recommended for the accurate identification of LVH. These findings highlight the need for comprehensive cardiac evaluation in athletes to distinguish between physiological and pathological adaptations.