{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:01:09Z","timestamp":1789646469555,"version":"4.0.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Low QRS voltages (LQRSV) in limb leads and QRS fragmentation (FQRS) are possible electrocardiographic signs of myocardial fibrosis and cardiomyopathy, but they are not listed in current criteria for interpreting athlete\u2019s electrocardiogram (ECG). We investigated the prevalence and determinants of LQRSV and FQRS in a cohort of young apparently healthy athletes undergoing pre-participation screening (PPS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We analysed a consecutive series of 2140 ECG obtained during PPS of young athletes (mean age 12.5 \u00b1 2.6 years, 7\u201318-year-old, 49% males). The peak-to-peak QRS voltage was measured in all limb leads, and LQRSV were defined when maximum value was &amp;lt;0.5\u2005mV. Fragmented QRS morphologies were grouped into five patterns. Lead aVR was not considered. Maximum peak-to-peak QRS voltage in limb leads was 1.4 \u00b1 0.4\u2005mV, similar between younger and older athletes, but significantly lower in females than males (1.35 \u00b1 0.38\u2005mV vs. 1.45 \u00b1 0.42\u2005mV; P &amp;lt; 0.001). There was a weak correlation between maximal QRS voltages and body mass index (BMI), but not with type of sport or training load. Only five (0.2%) individuals showed LQRSV. At least one fragmented QRS complex was identified in 831 (39%) individuals but excluding the rSr\u2032 pattern in V1\u2013V2, only 10 (0.5%) showed FQRS in \u22652 contiguous leads. They were older than those without FQRS, but did not differ in terms of gender, BMI, type of sport, or training load.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Low QRS voltages in limb leads and FQRS in \u22652 contiguous leads excluding V1\u2013V2 are rare in young apparently healthy athletes and are not related to the type and intensity of sport activity. Therefore, they may require additional testing to rule out an underlying disease particularly when other abnormalities are present.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwae180","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T16:32:23Z","timestamp":1716395543000},"page":"1535-1542","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence and determinants of low QRS voltages and QRS fragmentation in children and adolescents undergoing sports pre-participation screening"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0174-846X","authenticated-orcid":false,"given":"Francesca","family":"Graziano","sequence":"first","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova , Italy"},{"name":"Department of Sports Medicine, Semmelweis University , Budapest , Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Edoardo","family":"Genta","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova , Italy"},{"name":"Cardiovascular Department, University of Milan , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Manfrin","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova , Italy"},{"name":"Cardiovascular Department, University of Trieste , Trieste , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1487-0392","authenticated-orcid":false,"given":"Domenico","family":"Corrado","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Brusamolin","sequence":"additional","affiliation":[{"name":"Sports Medicine Unit, AULSS6 , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Giada","sequence":"additional","affiliation":[{"name":"Sports Medicine and Cardiovascular Rehabilitation Unit, AULSS3 , Noale , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Gerbino","sequence":"additional","affiliation":[{"name":"Sports Medicine and Cardiovascular Rehabilitation Unit, AULSS3 , Noale , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Compagno","sequence":"additional","affiliation":[{"name":"Sports Medicine and Cardiovascular Rehabilitation Unit, AULSS3 , Noale , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3578-0583","authenticated-orcid":false,"given":"Alessandro","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova , Via Giustiniani 2, 35128 Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"2024090611512544100_zwae180-B1","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1093\/eurheartj\/ehad288","article-title":"Pre-participation screening for safe sports activity","volume":"44","author":"Corrado","year":"2023","journal-title":"Eur Heart J"},{"key":"2024090611512544100_zwae180-B2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.jelectrocard.2015.02.001","article-title":"The effectiveness of screening history, physical exam, and ECG to detect 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