Electrocardiography Findings in Iranian Premier League Football Players

  • Hooman Angoorani Department of Sports and Exercise Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  • Mohamadsadegh Haghi Department of Sports and Exercise Medicine, Hazrat Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Keywords: Professional Football Players, Echocardiography, ECG Findings, Sudden Cardiac Death


Background: Sudden cardiac death (SCD) is the leading cause of death in athletes during sport. Electrocardiography (ECG) is a useful tool to detect underlying cardiovascular conditions that may increase the risk for SCD. The aim of the present study is to evaluate common ECG changes among professional football players. Materials and Methods: All football players of Iranian Premier League in season 2013-2014 participated in this descriptive study (258 football players). The standard 12-lead ECGs were evaluated and ECG analysis was performed according to previously described criteria. Results: Electrocardiogram evaluation showed that the percent of ECG changes was as follows; Inverted T (7.7%), Depression ST (2.3%), Bradycardia (0.3%), St Elevation (2.7%), Left ventricular hypertrophy (1.5%), Left bundle branch block (0.3%), Incomplete right bundle branch (0.3%), Incomplete left anterior bundle (0.8%), branch Incomplete left posterior bundle branch (1.1%), Wolf Parkinson white (0.3%), Left axis deviation (1.5), Right axis deviation (2.3%), ECG finding in favor of HCM (3.1%) and finally ECG finding in favor of IHD(10%). Conclusion: Most electrocardiographic variables in Iranian professional football players were lower than the worldwide football players that may be related to the lower level of physical fitness among Iranian football players.[GMJ.2015;4(4):151-58]


Pelliccia A, Maron BJ, De Luca R, Di Paolo FM, Spataro A, Culasso F. Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation. 2002;105(8):944-9.

Rawlins J, Bhan A, Sharma S. Left ventricular hypertrophy in athletes. Eur J Echocardiogr: the journal of the Working Group on Echocardiography of the European Society of Cardiology. 2009;10(3):350-6.

Biffi A, Pelliccia A, Verdile L, Fernando F, Spataro A, Caselli S, et al. Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol. 2002;40(3):446-52.

Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991;324(5):295-301.

Montgomery HE, Clarkson P, Dollery CM, Prasad K, Losi MA, Hemingway H, et al. Association of angiotensin-converting enzyme gene I/D polymorphism with change in left ventricular mass in response to physical training. Circulation. 1997;96(3):741-7.

Pelliccia A, Maron BJ, Culasso F, Di Paolo FM, Spataro A, Biffi A, et al. Clinical significance of abnormal electrocardiographic patterns in trained athletes. Circulation. 2000;102(3):278-84.

Maron BJ, Pelliccia A, Spirito P. Cardiac disease in young trained athletes. Insights into methods for distinguishing athlete's heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation. 1995;91(5):1596-601.

Corrado D, Pelliccia A, Heidbuchel H, Sharma S, Link M, Basso C, et al. Recommendations for interpretation of 12-lead electrocardiogram in the athlete. Eur heart j. 2010;31(2):243-59.

Barbier J, Ville N, Kervio G, Walther G, Carre F. Sports-specific features of athlete's heart and their relation to echocardiographic parameters. Herz. 2006;31(6):531-43.

Rich BS, Havens SA. The athletic heart syndrome. Current sports medicine reports. 2004;3(2):84-8.

Corrado D, Basso C, Thiene G. Essay: Sudden death in young athletes. Lancet (London, England). 2005;366 Suppl 1:S47-8.

Corrado D, McKenna WJ. Appropriate interpretation of the athlete's electrocardiogram saves lives as well as money. Eur heart j. 2007;28(16):1920-2.

Holly RG, Shaffrath JD, Amsterdam EA. Electrocardiographic alterations associated with the hearts of athletes. Sports medicine (Auckland, NZ). 1998;25(3):139-48.

Lakdawala NK, Thune JJ, Maron BJ, Cirino AL, Havndrup O, Bundgaard H, et al. Electrocardiographic features of sarcomere mutation carriers with and without clinically overt hypertrophic cardiomyopathy. Am J Cardiol. 2011;108(11):1606-13.

Tanguturi VK, Noseworthy PA, Newton-Cheh C, Baggish AL. The electrocardiographic early repolarization pattern in athletes: normal variant or sudden death risk factor? Sports medicine (Auckland, NZ). 2012;42(5):359-66.

Rowin EJ, Maron BJ, Appelbaum E, Link MS, Gibson CM, Lesser JR, et al. Significance of false negative electrocardiograms in preparticipation screening of athletes for hypertrophic cardiomyopathy. Am J Cardiol. 2012;110(7):1027-32.

Eckart RE, Shry EA, Burke AP, McNear JA, Appel DA, Castillo-Rojas LM, et al. Sudden death in young adults: an autopsy-based series of a population undergoing active surveillance. J Am Coll Cardiol. 2011;58(12):1254-61.

Meyer L, Stubbs B, Fahrenbruch C, Maeda C, Harmon K, Eisenberg M, et al. Incidence, causes, and survival trends from cardiovascular-related sudden cardiac arrest in children and young adults 0 to 35 years of age: a 30-year review. Circulation. 2012;126(11):1363-72.

Uberoi A, Jain NA, Perez M, Weinkopff A, Ashley E, Hadley D, et al. Early repolarization in an ambulatory clinical population. Circulation. 2011;124(20):2208-14.

Tikkanen JT, Anttonen O, Junttila MJ, Aro AL, Kerola T, Rissanen HA, et al. Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med. 2009;361(26):2529-37.

Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, et al. Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation. 2011;123(23):2666-73.

Junttila MJ, Sager SJ, Freiser M, McGonagle S, Castellanos A, Myerburg RJ. Inferolateral early repolarization in athletes. J Interv Card Electrophysiol. 2011;31(1):33-8.

Noseworthy PA, Weiner R, Kim J, Keelara V, Wang F, Berkstresser B, et al. Early repolarization pattern in competitive athletes: clinical correlates and the effects of exercise training. Circulation Arrhythmia and electrophysiology. 2011;4(4):432-40.

Dabrowska B. [Recommendations for the standardization and interpretation of the electrocardiogram according to the American Heart Association Electrocardiography and Arrhythmias Committee and the Heart Rhythm Society 2007 and 2009 - new standards]. Kardiologia polska. 2009;67(10):1128-32.

Corrado D, Biffi A, Basso C, Pelliccia A, Thiene G. 12-lead ECG in the athlete: physiological versus pathological abnormalities. Br J Sports Med. 2009;43(9):669-76.

Le VV, Wheeler MT, Mandic S, Dewey F, Fonda H, Perez M, et al. Addition of the electrocardiogram to the preparticipation examination of college athletes. Clin J Sport Med. 2010;20(2):98-105.

Papadakis M, Carre F, Kervio G, Rawlins J, Panoulas VF, Chandra N, et al. The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin. Eur heart j. 2011;32(18):2304-13.

Moore EN, Boineau JP, Patterson DF. Incomplete right bundle-branch block. An electrocardiographic enigma and possible misnomer. Circulation. 1971;44(4):678-87.

Langdeau JB, Blier L, Turcotte H, O'Hara G, Boulet LP. Electrocardiographic findings in athletes: the prevalence of left ventricular hypertrophy and conduction defects. Can J Cardiol. 2001;17(6):655-9.

Rao AL, Salerno JC, Asif IM, Drezner JA. Evaluation and management of wolff-Parkinson-white in athletes. Sports health. 2014;6(4):326-32.

How to Cite
Angoorani, H., & Haghi, M. (2015). Electrocardiography Findings in Iranian Premier League Football Players. Galen Medical Journal, 4(4), 151-58. https://doi.org/10.31661/gmj.v4i4.381
Original Article